title: Acid-base disturbances in acute poisoning and their association with survival.
abstract: The purpose was to investigate the association between acid-base disturbances and mortality in acute poisoning.
  
  
  
  We performed a retrospective cross-sectional exploratory study on all acutely poisoned patients older than 12 years who had been admitted to the main tertiary toxicology hospital in Tehran between March and August 2010.
  
  
  
  Of a total of 1167 patients (median age=25 years, 50.9% male), 98 died (74.5% male). Psychotropic medications were the most common cause of poisoning (36.5%), whereas narcotics and psychodysleptics were the most common cause of death (23.5%). Mixed respiratory alkalosis and metabolic acidosis with normal pH were the most common acid-base status (333, 28.5%). However, patients with primary metabolic acidosis and respiratory compensation had significantly higher mortality (31 cases, 18.8%). Logistic regression analysis identified age (odds ratio [OR], 1.051; 95% confidence interval [CI], 1.031-1.070; P<.001), intensive care unit admission (OR, 12.405; 95% CI, 7.178-21.440; P<.001), consciousness level (OR, 1.752; 95% CI, 1.301-2.359; P<.001), hospitalization period (OR, 1.1361; 95% CI, 1.079-1.195; P<.001), severe metabolic acidosis (OR, 6.016; 95% CI, 1.647-21.968; P=.007), and primary respiratory alkalosis (OR, 5.579; 95% CI, 1.353-23.001; P=.017) as death predictors during hospitalization (P<.001).
  
  
  
  On-arrival acid-base status predicts survival and can be used in prognostication of the poisoned patients.
authors.affiliation: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Haleh
authors.initials: H
authors.lastname: Hamdi
authors.affiliation: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Excellence Center of Clinical Toxicology, Ministry of Health and Medical Education, Tehran, Iran. Electronic address: hassanian@sbmu.ac.ir.
authors.forename: Hossein
authors.initials: H
authors.lastname: Hassanian-Moghaddam
authors.affiliation: Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Amir
authors.initials: A
authors.lastname: Hamdi
authors.affiliation: Department of Nephrology, Loghman-Hakim Hospital, Shahid Beheshti University, Tehran, Iran.
authors.forename: Narges Sadat
authors.initials: NS
authors.lastname: Zahed
mesh_terms: D000138:Acidosis / Q000401:mortality* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D003422:Critical Care; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007362:Intensive Care Units; D007492:Iran; D008297:Male; D008875:Middle Aged; D000067716:Point-of-Care Testing; D011041:Poisoning / Q000401:mortality* / Q000503:physiopathology; D011619:Psychotropic Drugs / Q000506:poisoning*; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D011619:Psychotropic Drugs
keywords: Care management; Critical care; Drug abuse; Drugs; Emergency medicine; Severity of illness