title: Risk Factors for Mortality and Endotracheal Intubation after Methadone Intoxication.
abstract: This was a retrospective chart review to evaluate various risk factors associated with in-hospital mortality and intubation risk in acute methadone overdose. All patients admitted to an academic hospital in Tehran, Iran, during a 10-year period (2000-2009) constituted the study sample. Exclusion criteria were significant comorbidities and age under 18 years. Outcome variables were in-hospital mortality and being intubated during admission. A total of 802 patients were enrolled in the study. There were 15 (1.8%) deaths due to methadone overdose or its complications. The number of yearly admissions was 15 patients in 2000, 16 in 2001, 16 in 2002, 18 in 2003, 23 in 2004, 38 in 2005, 59 in 2006, 110 in 2007, 206 in 2008 and 301 in 2009. Based on logistic regression analysis, the most important independent variable predicting mortality was length of admission in toxicology ward [OR (95% CI): 1.6 (1.1-2.3)]. For the prediction of intubation, independent variables were Glasgow Coma Scale (GCS) score of 5-9 [OR (95% CI): 356.5 (9.8-12907.4)] in the emergency department (ED), miosis in the ED [356.9 (1.4-87872.5)] and respiratory rate in the ED [1.5 (1.1-2.1)]. Linear regression model for length of hospitalization showed patient age as the most important variable for prediction of this outcome. Despite a relatively low mortality rate, the increasing number of methadone-poisoned patients requires special attention to this common intoxication. Careful disposition of patients from ED to ordinary wards or intensive care units and also from higher to lower levels of care should be considered in methadone overdose.
authors: Department of Clinical Toxicology, Loghman-Hakim Hospital, School of Medicine, Shahid-Beheshti University of Medical Sciences, Tehran, Iran.|Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran.
authors: Hossein
authors: H
authors: Hassanian-Moghaddam
authors: Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization of Iran, Tehran, Iran.
authors: Kambiz
authors: K
authors: Soltaninejad
authors: Department of Clinical Toxicology, Loghman-Hakim Hospital, School of Medicine, Shahid-Beheshti University of Medical Sciences, Tehran, Iran.|Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran.
authors: Shahin
authors: S
authors: Shadnia
authors: Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.|Department of Epidemiology, School of Public Health, Shahid-Beheshti University of Medical Sciences, Tehran, Iran.
authors: Ali
authors: A
authors: Kabir
authors: Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran.
authors: Mitra
authors: M
authors: Movahedi
authors: Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran.
authors: Amirhossein
authors: A
authors: Mirafzal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062787:Drug Overdose / Q000401:mortality*; D004636:Emergency Service, Hospital; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D007492:Iran; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008691:Methadone / Q000633:toxicity*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D023382:Toxicity Tests, Acute; D055815:Young Adult
chemical_list: D008691:Methadone