title: [Visits to the emergency department due to ecstasy (MDMA) and amphetamine derivative consumption: Epidemiological, clinical and evolutional profile].
abstract: OBJECTIVE
  To describe clinical and epidemiologic characteristics of emergency department visits related with ecstasy usage, determine the rate of re-visits of the patients and their related factors.
  
  
  METHODS
  The clinical histories of the patients coming to the Emergency Department for ecstasy-related problems were reviewed during 89 consecutive months in order to define the epidemiological and clinical profile. The computerized system of admission was used to study re-visits to the emergency department, reviewing the clinical history of the re-visits to see if they were related with drug consumption.
  
  
  RESULTS
  The study included 498 cases (71% male, mean age 26.5 years). The majority of the patients were attended on the weekend (66.6%) and at night (57%). Main complaints were anxiety or altered thoughts (32.8%), agitation (17.2%), impaired awareness level (7.2%) and convulsions or abnormal movements (5.6%). A total of 81% of the patients had consumed other substances besides ecstasy, mainly ethanol (53%), cocaine (36%) and gammahydroxibutirate (liquid ecstasy, 25%). Twenty six patients (5%) required admission to hospital (6 in the intensive care unit) and 4 died (0.8%). Fifteen percent of the patients were re-attended in the same ED for drug-related problems after a mean follow-up of 3 years, the new visit being more frequent during the first months. The need for an urgent psychiatric visit (OR: 6.3; 95% CI: 2.9-12.8) and hospital admission (OR: 3.5; 95% CI: 1.5-8.4) during their first ED attendance were independently associated with a greater risk of re-attendance.
  
  
  CONCLUSIONS
  Ecstasy consumption frequently leads to an ED visit, sometimes due to severe medical complications, and at least 15% of patients will need urgent care again for drug-related problems within the next 3 years. This likelihood increases along with increased severity of the index episode (need of psychiatric consultation or hospital admission).
authors.affiliation: Sección de Urgencias Medicina, Area de Urgencias, Hospital Clínic, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Galicia
authors.forename: S
authors.initials: S
authors.lastname: Nogué
authors.forename: E
authors.initials: E
authors.lastname: Sanjurjo
authors.forename: O
authors.initials: O
authors.lastname: Miró
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019969:Amphetamine-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D004630:Emergencies / Q000453:epidemiology; D004636:Emergency Service, Hospital; D005260:Female; D006213:Hallucinogens / Q000506:poisoning*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000506:poisoning*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine