Asociación de otras drogas de abuso en la intoxicación por cocaína / Cocaine intoxication in association with other drugs of abuse

RESUMEN

El objetivo del presente trabajo ha sido llevar a cabo un análisis de las urgencias atendidas en un hospital urbano de tercer nivel que se han relacionado con el consumo de cocaína. Para ello se ha realizado un estudio retrospectivo, con exclusión del área de pediatría y ginecología, durante los años 2005 y 2006. Se revisaron todas las asistencias clínicas que consultaron por intoxicación por cocaína. Los datos fueron analizados con el paquete estadístico SPSS 15.0 para windows. Durante el periodo de estudio se produjeron 1.531 intoxicaciones (1,2% del total de las urgencias). De éstas, 327 eran por cocaína (21,4% de las intoxicaciones). La edad media fue de 31 (8) años y la moda de 26 años. Un 76,5% eran varones. El 69,1% ingresaron en ambulancia. La mayor afluencia se produjo en fin de semana (46,8%) y en horario nocturno (54,1%). El 53,2% eran consumidores habituales y el 25,4% esporádicos. Un 55,7% asociaron más de 2 drogas: el 53,5% alcohol, el 31,2% opiáceos, el 17.4% benzodiacepinas, el 17,1% cannabis, el 11,3% GHB y el resto otras drogas. El 77,1% consumieron en un lugar público. Tenían antecedentes de intoxicaciones previas un 59,3%. El 93% presentaban síntomatología: (52,6% neurológicos, 48% conductuales, 28,4% cardiovasculares, 19% respiratorios y 8,3% digestivos). Se administraron antídotos a un 20,5%. El destino final fue alta en las primeras 12 horas en el 60,9%, con solo un 5,7% de ingresos. Se realizó valoración psiquiátrica en el 21,1%. En conclusión, el perfil del usuario que consulta por intoxicación por cocaína es un varón de 26 años traído en ambulancia de un lugar público, en fin de semana, en horario nocturno, consumidor habitual, con sintomatología cardiológica y neurológica y dado de alta en menos de 12 horas. La intoxicación aguda por cocaína no es pura. Destaca la asociación de alcohol, opiáceos y benzodiacepinas. Menos de una cuarta parte fueron valorados por Psiquiatría (AU)

ABSTRACT

The main of this study was to analyze all patients with cocaine intoxication attended in the emergency department of a tertiary-care hospital. For this, a retrospective study for the years 2005 and 2006, excluding peadiatric and gynecological areas, has been carried out. All cases in which the main reason for seeking urgent medical care was cocaine intoxication were reviewed. Data were analyzed with the SPSS statistical package (version 15.0) for Windows. During the study period, a total of 1531 subjects with drug of abuse intoxication were attended, which accounted for 1.2% of all patients attended in the emergency department. Cocaine was the drug of abuse responsible for the intoxication in 327 cases (21.4% of all intoxications). The mean (SD) age of the patients was 31 (8) years (mode 26 years). A total of 76.5% were men, and 69.1% arrived to the emergency department in ambulance. A large percentage of subjects were attended on weekends (46.8%) and during the night shift (54.1%). A total of 53.2% were regular cocaine consumers and 25.4% consumed the drug sporadically. In 55.7% of the cases, more than two drugs were concomitantly consumed, including alcohol in 53.5% of cases, opioids in 31.2%, benzodiazepines in 17.4%, cannabis in 17.1%, gamma hydroxybutyric acid in 11.3%, and other drugs in the remaining cases. Drugs were consumed in a public place in 77.1% of cases. History of previous episodes of intoxication was recorded in 59.3% of cases. Symptoms were present in 93% of subjects (neurological in 52.6%, behavioural in 48%, cardiovascular in 28.4%, respiratory in 19%, and gastrointestinal in 8.3%). Antidotes were administered in 20.5% of cases. A total of 60.9% of subjects were discharged from the emergency department within the first 12 hours and only 5.7% were admitted to the hospital. Twenty-one percent of subjects underwent psychiatric assessment. In conclusion, the profile of a subject with cocaine intoxication attended in the emergency department is a man of 26 years of age, transferred in ambulance from a public place, on weekends and at night, regular cocaine consumer, presenting with neurological and cardiological symptoms, and discharged from the emergency department in less than 12 hours after admission. Cocaine intoxication occurred frequently in association with alcohol, opioids, and benzodiazepine use. Less than one fourth of subjects underwent psychiatric assessment (AU)