title: Patterns of presentation in heroin overdose resulting in pulmonary edema.
abstract: The study objective was to describe the morbidity of patients presenting with heroin overdose (HOD)-induced noncardiogenic pulmonary edema (NCPE) at an urban ED. A retrospective chart review of patients presenting between 1996 and 1999 with the diagnosis of HOD was conducted. Using a standardized data abstraction form, information on prehospital care, ED care, demographics, and cointoxications was collected. One hundred twenty-five charts (78%) were available for review. Of these, 13 (10%) were diagnosed with NCPE and all were male. In the field, NCPE patients had an average relative risk of 6, a Glasgow Coma Scale of 4, and all needed naloxone. The average admitted duration of use was 2.9 years for those who developed NCPE compared with 13.2 years for those who did not. Five (42%) NCPE patients tested positive for cocaine use and 7 (58%) tested positive for alcohol. In this cohort, the NCPE patients were male and less experienced users with initial low relative risk and Glasgow Coma Scale which demanded prehospital naloxone use. (Am J Emerg Med 2003;21:32-34.
authors.affiliation: Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Sterrett
authors.forename: Joseph
authors.initials: J
authors.lastname: Brownfield
authors.forename: Carrie S
authors.initials: CS
authors.lastname: Korn
authors.forename: Mark
authors.initials: M
authors.lastname: Hollinger
authors.forename: Sean O
authors.initials: SO
authors.lastname: Henderson
mesh_terms: D000328:Adult; D015331:Cohort Studies; D062787:Drug Overdose; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D003932:Heroin / Q000506:poisoning*; D006556:Heroin Dependence / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000506:poisoning*; D011654:Pulmonary Edema / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D009294:Narcotics; D003932:Heroin