Immediate and 30 days mortality in digoxin poisoning cases attended in the Hospital Emergency Services of Catalonia, Spain.

Abstract

OBJECTIVES:

Digoxin poisoning is a frequent reason for seeking emergency care. This study aimed to assess mortality related to digoxin poisoning.

MATERIAL AND METHODS:

Descriptive observational study of digoxin poisonings attended in the emergency departments of 4 hospitals in Catalonia from 2013 through 2015. We gathered data relevant to the poisonings and recorded immediate and 30-day mortality. Factors possibly related to mortality were explored.

RESULTS:

A total of 171 digoxin poisonings were attended. Seven (4.1%) were acute and 164 (95.9%) were chronic. The immediate and 30-day mortality rates were 6.4% and 13.4%, respectively. Bivariate analysis did not identify factors related to immediate mortality. However, the variables more often associated with 30-day mortality in this analysis were acute poisoning (after which 13% died vs 2.7% of those with chronic poisoning, P=.05), suicide attempts (8.7% of whom died vs 0.7%, P=.048), more compromised renal function (21.7% vs 9.5%, P=.037), fewer neurologic symptoms (4.3% vs 17.8% with more symptoms, P=.005), higher mean digoxin concentrations (4.7 mg/dL in those who died vs 3.7 mg/dL, P=.027), and a lower Barthel index (mean [SD] 49.1 [33.4] in those who died vs 70.3 [28.5]; P=.006). Logistic regression analysis identified serum digoxin concentration to be independently associated with immediate mortality. A lower Barthel index was associated with 30-day mortality.

CONCLUSION:

Immediate mortality is related to a high digoxin concentration in serum, and 30-day mortality to a low Barthel index.

• Authors: August Supervía Caparrós, Emilio Salgado García, Xavier Calpe Perarnau, Miguel Galicia Paredes, Lidia García Gibert, Francisca Córdoba Ruiz, Carlos Clemente Rodríguez, Santiago Nogué Xarau
• Journal: Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias (Emergencias) Vol. 31 Issue 1 Pg. 39-42 (02 2019) ISSN: 2386-5857 [Electronic] Spain
• Vernacular Title: Mortalidad inmediata y a los 30 días en las intoxicaciones digitálicas atendidas en servicios de urgencias de Cataluña.
• PMID: 30656872 (Publication Type: Journal Article, Multicenter Study, Observational Study)

Chemical References

• Enzyme Inhibitors
• Digoxin

Topics

• Adult
• Aged
• Aged, 80 and over
• Digoxin (blood, poisoning)
• Emergency Service, Hospital
• Enzyme Inhibitors (blood, poisoning)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Poisoning (blood, diagnosis, mortality)
• Spain (epidemiology)