Accuracy of information on substance use recorded in medical charts of patients with intentional drug overdose.
Psychoactive substance use is a risk factor for suicidal behavior and current intoxication increases the likelihood of serious intentional drug overdose (IDO). The objective was to assess the accuracy of information on substance use recorded in medical charts using toxicological assays as a reference in subjects admitted for IDO to an emergency department. Patients (n=1190) consecutively admitted for IDO were included. Information on substance use was recorded in routine practice by the emergency staff and toxicological assays (cannabis, opiate, buprenorphine, amphetamine/ecstasy, cocaine, LSD) were carried out in urine samples collected as part of routine management. The information on substance use was recorded in medical charts for 24.4% of subjects. A third of subjects (27.5%) were positive for toxicological assays. Recorded substance use allowed correct classification of nearly 80% of subjects. However, specificity (88.6%) was better than sensitivity (54.2%). Compared with toxicological assays, medical records allowed identification of only half of the subjects with current substance use. The usefulness of systematic toxicological assays during hospitalization for IDO should be assessed in further studies exploring whether such information allows medical management to be modified and contributes to improving prognosis.
Tournier
Marie
M
Unité INSERM U657, Université Victor Segalen Bordeaux2, 146 rue Leo Saignat, 33076 Bordeaux, France. mtournier@perrens.aquisante.fr
Molimard
Mathieu
M
Titier
Karine
K
Cougnard
Audrey
A
Bégaud
Bernard
B
Gbikpi-Benissan
Georges
G
Verdoux
Hélène
H
D000328:Adult; D003430:Cross-Sectional Studies; D004282:Documentation; D062787:Drug Overdose / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine; D005260:Female; D005602:France; D006760:Hospitalization; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning* / Q000652:urine; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000506:poisoning* / Q000652:urine; D012008:Recurrence; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D014342:Truth Disclosure
D013287:Illicit Drugs; D011619:Psychotropic Drugs