İntihar Amaçlı İlaç Alımı Nedeni ile Acil Servise Başvuran Hastalarda Rabdomiyolizin Araştırılması: Prospektif Orijinal Klinik Çalışma

Objective: Drug-induced rhabdomyolysis is the most common cause of disorders leading to acquired muscular inflammation. The aim of this study is to investigate rhabdomyolysis frequency in patients admitted to the emergency room (ER) due to one or different types of multiple drug ingestion with suicidal intentions. Material and Methods: This prospective clinical study was performed between June 2013 and November 2013 in Dr. Lütfi Kırdar Kartal Training and Research Hospital’s ER, which had a daily admittance average of 800-1000 patients. The study included 103 patients. Creatinephosphokinase in the blood and myoglobin in the urine examined at the 3rd , 6th, 12th and 24th hours of admission to the ER. Results: Of the patients, 77 (74.8%) were female and 26 (25.2%) were male. Mean age was 28.8±9.5 years. Male subjects ingested a greater variety and a greater number of drugs than female subjects (p<0.05). Creatine phosphokinase level was found to be higher in the patients who took a higher number of drugs. Creatine phosphokinase was higher than 171 (U/L) in 15 patients (14.6%). Myoglobinuria was detected in 7.8% of all patients. No rhabdomyolysis was observed in patients who were admitted to the hospital within the first 3 hours of ingestion. The most commonly used agent for suicide attempt was non-steroidal antiinflammatory drugs (NSAIDs) (36.9%), paracetamol (31.1%) and antidepressants (30.1%). Conclusion: It was found that patients with delayed admission to the ER had a higher incidence of rhabdomyolysis. Antidepressants were the third leading agents used for suicidal intentions following NSAIDs and paracetamol.Amaç: İlaçların tetiklediği rabdomiyoliz kazanılmış kas inflamasyonu nedenlerinden en sık olanıdır. Bu çalışmanın amacı öz kıyım amaçlı bir veya farklı türde çok miktarda ilaç alımı nedeni ile acil servise kabul edilen hastalarda rabdomiyoliz sıklığını araştırmaktır. Gereç ve Yöntemler: Bu prospektif klinik çalışma günlük ortalama 800-1000 hastanın başvurduğu Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi Acil servisinde 2013 yılı Haziran ve Kasım ayları arasında yapıldı. Çalışmaya 103 hasta dahil edildi. Hastaların acil servise kabulünden sonra 3’üncü, 6’ıncı, 12’inci ve 24’üncü saatlerde kan kreatin fosfokinaz ve idrarda miyoglobin değerlerine bakıldı. Bulgular: Hastaların 77’si (%74,8) kadın ve 26’sı (%25,2) erkekti. Yaş ortalamaları 28,8±9,5 yıldı. Erkek hastalar kadın hastalardan daha fazla miktarda ve çeşitte ilaç almışlardı (p