Epidemiology of acute poisonings with gammahydroxybutyric acid in Saint Petersburg (according to data of a multidisciplinary hospital)

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Abstract

It was found that for the period from X.2017 to III.2020 among patients admitted to a multidisciplinary hospital with acute poisoning with narcotic drugs (NV) and psychoactive substances (PAS), persons in whose biological environment GHB was detected ranged from 20,1 to 40,1%. The prevalence of acute poisoning of the studied class in male patients (86%) of working age (the average age was 34,2 ± 2,9 year) was proved. The patients used 1,4-butanediol (1,4-BD) as a toxicant (GHB) in 95% of cases. The dynamics of the incidence of acute GHB poisoning over a three-year period was uneven, with peaks of maximum values in August (Me = 168), March (Me = 90), and September (Me = 103) and low rates - in June (Me = 71) and total upward trend - y = 6,6573x = 343,23, R2 = 0,053. The severity of acute GHB poisoning at the time of admission on the PSS scale was 2,2 ± 0,57 points, PSSSP – 22,7 ± 2,17 points. Acute GHB poisoning was characterized by signs of toxic-hypoxic encephalopathy, clinically manifested in the form of depression of consciousness to the level of deep stunning - coma. The duration of inpatient treatment of patients was (1,76 ± 3,7, min = 1, max = 35) days, the period of stay in the intensive care unit (ICU) was 4,2 ± 0,4 hours. The increase in hospitalization (more than a day) was due to somatic complications of acute poisoning (nasocomial pneumonia, systemic rhabdomyolysis, acute renal failure) - in 14% of cases, severe withdrawal syndrome with delirious confusion - in 3,5% of cases. The post-intoxication period was characterized by moderate withdrawal symptoms – 13,7 ± 2,1 points, according to the CIWA-Ar scale. The delirious syndrome was characterized by a protracted course (9,5 ± 1,2 days), an atypical clinical picture, and metabolic disorders. The mortality rate due to acute GHB poisoning increased from 0,09 to 0,22%, in 2019 the cause of death was pronounced degenerative changes in internal organs and varying degrees of severity of microcirculation disorders.

About the authors

A. G. Sinenchenko

Saint Petersburg I.I. Dzhanelidze Research Institute of Emergency Care

Author for correspondence.
Email: andreysin2013@yandex.ru

Sinenchenko Andrej Georgievich

192242, Saint Petersburg

Russian Federation

A. N. Lodyagin

Saint Petersburg I.I. Dzhanelidze Research Institute of Emergency Care

Email: fake@neicon.ru

Lodyagin Aleksej Nikolaevich

192242, Saint Petersburg

Russian Federation

B. V. Batotsyrenov

Saint Petersburg I.I. Dzhanelidze Research Institute of Emergency Care

Email: fake@neicon.ru

Batotsyrenov Bair Vasil’evich

192242, Saint Petersburg

Russian Federation

O. L. Balabanova

Saint Petersburg I.I. Dzhanelidze Research Institute of Emergency Care

Email: fake@neicon.ru

Balabanova Olga Leonidovna

192242, Saint Petersburg

Russian Federation

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Copyright (c) 2021 Sinenchenko A.G., Lodyagin A.N., Batotsyrenov B.V., Balabanova O.L.



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