According to a previous study, 17% of patients who attended
an emergency department (ED) following cocaine use returned to the same ED over
the next year for a problem related to drug use. This previous study proposed a
scale (Multicenter Assessment of the Revisit Risk In the Emergency Department
(MARRIED)-cocaine score) to quantify the risk of ED revisit. The aim of the
present study was to validate this scale by analysing a new set of patients
attending for cocaine use in nine Spanish EDs.
We performed a retrospective, multicentre, cohort study with
consecutive patient inclusion, and without an intervention or control group.
During 12 months (January-December 2010) we collected data from patients
attending the ED after cocaine use. The MARRIED-cocaine score, ranging from 0
to 400 points, was calculated for each patient. The dependent variable was the
identification of further visits associated with drug consumption to the same
ED. Further analysis was performed to define risk categories.
The study included 933 patients, with a mean follow-up of
466 (SD 189) days, and 185 patients returned to the same ED for problems
related to drug consumption. The cumulative probability of ED revisit was 4.2%,
8.3%, 16.8% and 21.2% at 1 month, 3 months, 12 months and 24 months,
respectively. The area under the curve receiver operating characteristic for
the MARRIED-cocaine scale was 0.69 (p<0.001). Four categories for ED revisit
risk were defined: low risk (0-40 points, n=416), moderate risk (41-100 points,
n=235), high risk (101-210 points, n=71) and very high risk (210-400 points,
n=211), with HRs for ED revisit (with respect to the low-risk group) of 1.82, 2.65 and 5.06, respectively.
The MARRIED-cocaine score has a moderate discriminative
capacity to predict revisit among patients who attend the ED for cocaine
drug-related emergencies, and allows classification of patients according to
the risk of ED revisit.
Purchase full article
at:
By:
- 1Área de Urgencias, Hospital Clínic, Barcelona, Spain Grupo de Investigación "Urgencias: procesos y patologías", IDIBAPS, Barcelona, Spain.
- 2Grupo de Investigación "Urgencias: procesos y patologías", IDIBAPS, Barcelona, Spain Unidad de Toxicología Clínica, Hospital Clínic, Barcelona, Spain.
More at: https://twitter.com/hiv_insight
No comments:
Post a Comment