Risk Factors for Aspiration Pneumonia in Acute Benzodiazepine Overdose

벤조디아제핀 급성 중독에서 발생하는 흡인성 폐렴 위험 인자

  • Chung, Won Sik (Department of Emergency Medicine, Medical School, The Catholic University of Korea) ;
  • Cha, Kyung Man (Department of Emergency Medicine, Medical School, The Catholic University of Korea) ;
  • Kim, Hyung Min (Department of Emergency Medicine, Medical School, The Catholic University of Korea) ;
  • Jeong, Won Jung (Department of Emergency Medicine, Medical School, The Catholic University of Korea) ;
  • So, Byung Hak (Department of Emergency Medicine, Medical School, The Catholic University of Korea)
  • 정원식 (가톨릭대학교 의과대학 응급의학교실) ;
  • 차경만 (가톨릭대학교 의과대학 응급의학교실) ;
  • 김형민 (가톨릭대학교 의과대학 응급의학교실) ;
  • 정원중 (가톨릭대학교 의과대학 응급의학교실) ;
  • 소병학 (가톨릭대학교 의과대학 응급의학교실)
  • Received : 2016.05.16
  • Accepted : 2016.05.27
  • Published : 2016.06.30

Abstract

Purpose: Aspiration pneumonia is an important complication of drug intoxication with decreased mental status. The purpose of the study is to investigate the risk factors of aspiration pneumonia in the patients of benzodiazepine overdose with or without co-ingestion of other drugs. Methods: A retrospective chart review of patients who visited the emergency department between January 2012 and December 2014 was conducted. Demographic data, time from ingestion to visit, initial vital signs, symptoms, mental status, medical history, laboratory results, chest radiological findings and co-ingested medications were recorded. Multiple logistic analyses were performed to verify the association between variables and the development of aspiration pneumonia. Results: A total of 249 patients presented to the emergency department with benzodiazepine overdose. Aspiration pneumonia had developed in 24 patients (9.6%). Univariate analysis revealed time from ingestion to visit was longer, Glasgow coma scale score was lower, hypoxia was presented, leukocytosis was shown, types of ingested drugs was high, less activated charcoal was applied and tricyclic antidepressants was taken in patients that developed aspiration pneumonia. Time from ingestion to visit (odds ratio (OR) 1.121, 95% confidence interval (CI), 1.057-1.189, p=0.000), GCS score (OR 0.724. 95% CI, 0.624-0.839, p=0.000), oxygen saturation (OR 0.895, 95% CI, 0.835-0.959, p=0.002), and co-ingestion of TCA (OR 4.595, 95% CI, 1.169-18.063, p=0.029) were identified as risk factors of morbidity of aspiration pneumonia upon multiple logistic regression analysis. Conclusion: Time from ingestion to visit, low GCS score, low oxygen saturation and co-ingestion of TCA were risk factors of the development of aspiration pneumonia in benzodiazepine overdose patients.

Keywords

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