Acceso usuarios
Indira Vega Sánchez, Guillermo Burillo Putze, Dima Ibrahim-Achi, Miguel Galicia Paredes, Augusto Supervía Caparrós, Jordi Puiguriguer Ferrando, María de los Angeles López Hernández, Sebastián Matos Castro, Óscar Miró Andreu
OBJETIVOS. Conocer la incidencia de crisis convulsivas en las intoxicaciones agudas por drogas en España y sus características demográficas, toxicológicas y clínicas.
MATERIAL Y MÉTODO. Análisis de los pacientes del registro REDUrHE, estudio multicéntrico prospectivo de 24 meses de duración (2017-2019) en 11 servicios de urgencias hospitalarios españoles, que convulsionaron (PcC) tras una intoxicación aguda por drogas.
RESULTADOS. Presentaron convulsiones 243 pacientes (5,4%). El 79% eran hombres, sin hallarse diferencias significativas en las variables estudiadas en función del sexo. No se encontraron diferencias en la incidencia de convulsiones con los grupos de drogas, excepto para el grupo de sustancias desconocidas. Los pacientes sin convulsiones presentaban más palpitaciones (17,1% vs 5,3%;
p < 0,001), dolor torácico (9,4% vs 2,1%; p < 0,001), síntomas cerebelosos y ansiedad (26,5% vs 10,7%; p < 0,001). Se hallaron diferencias para los pacientes que convulsionaron en cuanto a intubación orotraqueal (3,3% vs 1,6%; p = 0,038), determinación de drogas en orina (91,8% vs 75,7%; p < 0,001), e ingresos en cuidados intensivos (UCI) (5,3% vs 1,8%; p < 0,001). No hubo diferencias en cuanto a estancia en urgencias o fallecimientos. Las variables intubación orotraqueal (OR = 2,161; IC 95% = 1,025-4,554), consumo de sustancia desconocida (OR = 2,222; IC 95% = 1,457-3,389) e ingreso en UCI (OR = 2,161; 95% IC = 1,025-4,554), aumentaban en 2,2 veces su probabilidad en los enfermos que presentaron un cuadro convulsivo. El consumo concomitante de alcohol (OR = 0,264;
IC 95% = 0,097-0,715) fue un factor contrario a convulsionar.
CONCLUSIONES. El riesgo de convulsión no se asocia con ningún grupo de drogas en particular, aunque este aumenta en el caso de no conocer la sustancia consumida.
OBJECTIVES. To estimate the incidence of seizures due to poisoning by street drugs in Spain and to describe the demographic, toxicologic, and clinical characteristics of the events.
METHODS. Prospective multicenter analysis of data from the registry of the Spanish Research Network on Drugs in Hospital Emergency Departments (REDUrHE), a 24-month project in 2017 to 2019 in 11 Spanish hospital emergency departments. The patients were treated for seizures after poisoning due to street drug use.
RESULTS. A total of 243 patients (in 5.4% of the cases registered) had seizures. Seventy-nine percent were men. No statistically significant differences between the sexes were found. A significantly higher incidence of seizures was observed only in the group of patients poisoned by unidentified substances. Patients without seizures had more palpitations (in 17.1% vs in 5.3% of those with seizures), chest pain (9.4% vs 2.1%, respectively), and cerebellar signs and anxiety (26.5% vs 10.7%) (P<.001, all comparisons).
Patients with seizures differed with respect to need for orotracheal intubation (in 3.3% vs 1.6% of those without seizures; P=.038), positive urine tests for drugs (91.8 % vs 75.7%; P<.001), and intensive care unit (ICU) admission (5.3% vs 1.8%; P<.001). Length of stay in the emergency department and mortality did not differ between patients with and without seizures. The following events were over twice as likely in patients who had seizures: orotracheal intubation, odds ratio (OR), 2.161 (95% CI, 1.025-4.54); use of an unidentified substance, OR, 2.222 (95% CI, 1.457-3.389); and ICU admission, OR, 2.161 (95% CI, 1.025-4.554). Coingestion of alcohol was not related to having seizures: OR, 0.264; 95% CI, 0.097-0.715).
CONCLUSION. A higher risk of seizure was not associated with any particular known street drug, although the risk increased when an unknown substance had been used.
