Routine biological tests in self-poisoning patients: results from an observational prospective multicenter study.
BACKGROUND
Routine biological tests are frequently ordered in self-poisoning patients, but their clinical relevance is poorly studied.


METHODS
This is a prospective multicentric observational study conducted in the emergency departments and intensive care units of 5 university and nonuniversity French hospitals. Adult self-poisoning patients without severely altered vital status on admission were prospectively included.


RESULTS
Routine biological test (serum electrolytes and creatinine, liver enzymes, bilirubin, blood cell count, prothrombin time) ordering and results were analyzed. A total of 1027 patients were enrolled (age, 40.2 ± 14 years; women, 61.5%); no patient died during the hospital stay. Benzodiazepine was suspected in more than 70% of cases; 65% (range, 48%-80%) of patients had at least 1 routine biological test performed. At least 1 abnormal test was registered in 23% of these patients. Three factors were associated with abnormal test results: age older than 40 years, male sex, and poisoning with a drug known to alter routine tests (ie, acetaminophen, NSAIDs, metformine, lithium). Depending on these factors, abnormal results ranged from 14% to 48%. Unexpected severe life-threatening conditions were recorded in 6 patients. Only 3 patients were referred to the intensive care unit solely because of abnormal test results.


CONCLUSIONS
Routine biological tests are commonly prescribed in nonsevere self-poisoning patients. Abnormal results are frequent but their relevance at bedside remains limited.
Angers University, Angers, France; Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers, France.
Thomas
T
Reydel
Department of Emergency Medicine, Le Mans Hospital, Le Mans, France.
Jean-Christophe
JC
Callahan
Department of Emergency Medicine, Saint Malo Hospital, Saint Malo, France.
Laurent
L
Verley
Department of Emergency Medicine, Brest University Hospital, Brest, France.
Christelle
C
Teiten
Department of Emergency Medicine, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Christophe
C
Andreotti
Department of Emergency Medicine, Centre Hospitalier Princesse Grace, Principauté de, Monaco.
Yann Erick
YE
Claessens
Clinical Research Center, Angers University Hospital, Angers, France.
David
D
Missud
Department of Emergency Medicine, Brest University Hospital, Brest, France.
Erwan
E
L'Her
Poison Center, Angers University Hospital, Angers, France.
Gael
G
Le Roux
Angers University, Angers, France; Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers, France. Electronic address: nicolas.lerolle@univ-angers.fr.
Nicolas
N
Lerolle
D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D011041:Poisoning / Q000175:diagnosis* / Q000378:metabolism; D011446:Prospective Studies; D016728:Self-Injurious Behavior / Q000175:diagnosis* / Q000378:metabolism
D015415:Biomarkers