This study was undertaken to evaluate the clinical utility and cost-effectiveness of the limited component versus the high performance liquid chromatography (HPLC) component of comprehensive toxicologic screens in children.
A retrospective patient series was studied at the emergency department (ED) of Hughes Spalding Children's Hospital, an urban, tertiary-care ED, consisting of all patients younger than 19 years of age who had a comprehensive toxicologic screen between January 1994 and July 1995.
The comprehensive test included a broad-spectrum HPLC component as well as a limited component that examined serum for ethanol, aspirin, and acetaminophen and urine for benzodiazepines, barbiturates, amphetamines, cocaine, phencyclidine, and opiates.
All toxicologic screens were reviewed for the presence of exogenous toxins, followed by a chart review of all patients with positive screens and a selection of negative screens.
Toxins were categorized as (1) iatrogenic or nonlatrogenic, (2) clinically or nonclinically suspected by history and physical, and (3) clinically or nonclinically significant.
Comprehensive toxicology screens were performed in 463 cases during the study period ; 234 (51%) were positive for exogenous toxins.
In 227 of 234 positive screens (97%), toxins were either suspected by history and/or physical, were present on the limited portion of the toxicology screen, or were clinically insignificant. (...)
Mots-clés Pascal : Toxicologie, Dépistage, Analyse coût efficacité, Chromatographie HPLC, Milieu urbain, Etats Unis, Amérique du Nord, Amérique, Enfant, Homme, Economie santé
Mots-clés Pascal anglais : Toxicology, Medical screening, Cost efficiency analysis, HPLC chromatography, Urban environment, United States, North America, America, Child, Human, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0279413
Code Inist : 002B03A. Création : 16/11/1999.