title: Clinical outcomes of adverse cardiovascular events in patients with acute dapsone poisoning.
abstract: OBJECTIVE
  Adverse cardiovascular events (ACVEs) account for a large proportion of the morbidities and mortalities associated with drug overdose emergencies. However, there are no published reports regarding outcomes of ACVEs associated with acute dapsone poisoning. Here, the authors retrospectively analyzed ACVEs reported within 48 hours of treatment in patients with acute dapsone poisoning and assessed the significance of ACVEs as early predictors of mortality.
  
  
  METHODS
  Sixty-one consecutive cases of acute dapsone poisoning that were diagnosed and treated at a regional emergency center between 2006 and 2014 were included in the study. An ACVE was defined as myocardial injury, shock, ventricular dysrhythmia, cardiac arrest, or any combination of these occurring within the first 48 hours of treatment for acute dapsone poisoning.
  
  
  RESULTS
  Nineteen patients (31.1%) had evidence of myocardial injury (elevation of serum troponin-I level or electrocardiography signs of ischemia) after dapsone overdose, and there were a total of 19 ACVEs (31.1%), including one case of shock (1.6%). Fourteen patients (23.0%) died from pneumonia or multiple organ failure, and the incidence of ACVEs was significantly higher among non-survivors than among survivors (64.3% vs. 21.3%, P=0.006). ACVE was a significant predictor of mortality (odds ratio, 5.690; 95% confidence interval, 1.428 to 22.675; P=0.014).
  
  
  CONCLUSIONS
  The incidence of ACVE was significantly higher among patients who died after acute dapsone poisoning. ACVE is a significant predictor of mortality after dapsone overdose, and evidence of ACVE should be carefully sought in these patients.
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Kang
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Hyung Il
authors.initials: HI
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Oh Hyun
authors.initials: OH
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kyoung Chul
authors.initials: KC
authors.lastname: Cha
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kang Hyun
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Sung Oh
authors.initials: SO
authors.lastname: Hwang
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Yong Sung
authors.initials: YS
authors.lastname: Cha
keywords: Cardiac injury; Dapsone; Intoxication; Mortality; Troponin I