North American Congress of Clinical Toxicology. Portland, OR, USA, 1996/09.
To evaluate the impact of a medical toxicology consulting service (MTCS) on resource use and efficiency of care in patients hospitalized with a diagnosis of tricyclic antidepressant (TCA) poisoning.
We conducted a retrospective, case-controlled medical-records review at two urban tertiary care teaching hospitals.
The study population comprised patients who presented to the emergency department with a diagnosis of TCA poisoning, in two phases.
The first phase was longitudinal ; we evaluated cases over 4 years before and after inception of an MTCS at one institution.
In the second phase we compared consecutive cases of TCA poisoning treated at two urban teaching hospitals located within a mile of each other with similar patient populations, one with and one without MTCS backup.
Inclusion criteria consisted of complete medical records, ingestion of first-or second-generation TCAs, and age greater than 16 years.
Patients were excluded if history, physical examination, or laboratory analysis suggested that multiple substances had been ingested.
Extensive demographic data were collected in each case.
Clinical information obtained from each patient included admission vital signs, pupil size, QRS and corrected QT duration, and the presence of markers of severe TCA toxicity such as hypotension, seizures, pulmonary edema, respiratory insufficiency necessitating intubation, and the occurrence of antimuscarinic signs and symptoms. (...)
Mots-clés Pascal : Toxicologie, Consultation, Service hospitalier, Intoxication, Antidépresseur, Pratique professionnelle, Evaluation performance, Etude comparative, Traitement, Exploration clinique, Etats Unis, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : Toxicology, Consultation, Hospital ward, Poisoning, Antidepressant agent, Professional practice, Performance evaluation, Comparative study, Treatment, Clinical investigation, United States, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0321710
Code Inist : 002B30A04D. Création : 27/11/1998.