Characteristics of digoxin toxicity attended in Spanish emergency departments according to type of poisoning and administration of digoxin antibodies : the DIGITOX study
OBJECTIVES: Digoxin toxicity accounts for a small percentage of poisonings attended by emergency departments. This study aimed to describe differences between acute and chronic digoxin toxicity and assess the use of digoxin-specific antibody fragments (digoxin-Fab) as an antidote.
MATERIAL AND METHODS: Retrospective, observational, multicenter study in 15 hospital emergency departments in 8 Spanish autonomous communities in 7 years. We collected patient, clinical and treatment variables, and discharge destination. Patients were classified according to whether toxicity was acute or chronic and whether digoxin-Fab was administered or not.
RESULTS: Twenty-seven acute and 631 chronic digoxin poisonings were attended. The mean (SD) patient age was 83.9 (7.9) years, and 76.9% were women. Patients with acute toxicity were younger (80.0 [12] years) than those with chronic toxicity (84.1 [7.7] years) (P .038), and accidental poisoning was less common (in 85.2% vs 100% in chronic toxicity; P .001). Cases of acute toxicity were also more serious (Poison Severity Score (29.6% vs 12.5% in chronic toxicity; P .001). Thirty-four patients were treated with digoxin-Fab (5.4%). These patients were younger (78.7 [11.5] years vs 84.2 (7.6) years), their toxicity was more often acute (in 20.6% vs 3.2% in chronic toxicity), more had attempted suicide (8.8% vs 0.2% with chronic toxicity), and more had severe symptoms (50% vs 11.2%) (P .001, all comparisons). Hospital admission was required for 76.1%. Overall, mortality was 11.4%.
CONCLUSION: Chronic toxicity accounts for most digoxin poisoning cases, and most patients are women. Acute toxicity is more serious. Patients who required digoxin-Fab have more severe poisoning. Such patients usually have acute toxicity, and attempted suicide is more often the reason for the emergency.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
|---|---|
| Enthalten in: |
Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias - 35(2023), 5 vom: 06. Okt., Seite 328-334 |
| Sprache: |
Spanisch |
|---|
| Weiterer Titel: |
Características de las intoxicaciones por digoxina atendidas en diversos servicios de urgencias españoles en función del tipo de intoxicación y de la administración de anticuerpos antidigoxina: estudio DIGITOX |
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| Beteiligte Personen: |
Supervía, August [VerfasserIn] |
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| Anmerkungen: |
Date Completed 08.11.2023 Date Revised 08.11.2023 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362950245 |
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| 245 | 1 | 0 | |a Characteristics of digoxin toxicity attended in Spanish emergency departments according to type of poisoning and administration of digoxin antibodies |b the DIGITOX study |
| 246 | 3 | 3 | |a Características de las intoxicaciones por digoxina atendidas en diversos servicios de urgencias españoles en función del tipo de intoxicación y de la administración de anticuerpos antidigoxina: estudio DIGITOX |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 08.11.2023 | ||
| 500 | |a Date Revised 08.11.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: Digoxin toxicity accounts for a small percentage of poisonings attended by emergency departments. This study aimed to describe differences between acute and chronic digoxin toxicity and assess the use of digoxin-specific antibody fragments (digoxin-Fab) as an antidote | ||
| 520 | |a MATERIAL AND METHODS: Retrospective, observational, multicenter study in 15 hospital emergency departments in 8 Spanish autonomous communities in 7 years. We collected patient, clinical and treatment variables, and discharge destination. Patients were classified according to whether toxicity was acute or chronic and whether digoxin-Fab was administered or not | ||
| 520 | |a RESULTS: Twenty-seven acute and 631 chronic digoxin poisonings were attended. The mean (SD) patient age was 83.9 (7.9) years, and 76.9% were women. Patients with acute toxicity were younger (80.0 [12] years) than those with chronic toxicity (84.1 [7.7] years) (P .038), and accidental poisoning was less common (in 85.2% vs 100% in chronic toxicity; P .001). Cases of acute toxicity were also more serious (Poison Severity Score (29.6% vs 12.5% in chronic toxicity; P .001). Thirty-four patients were treated with digoxin-Fab (5.4%). These patients were younger (78.7 [11.5] years vs 84.2 (7.6) years), their toxicity was more often acute (in 20.6% vs 3.2% in chronic toxicity), more had attempted suicide (8.8% vs 0.2% with chronic toxicity), and more had severe symptoms (50% vs 11.2%) (P .001, all comparisons). Hospital admission was required for 76.1%. Overall, mortality was 11.4% | ||
| 520 | |a CONCLUSION: Chronic toxicity accounts for most digoxin poisoning cases, and most patients are women. Acute toxicity is more serious. Patients who required digoxin-Fab have more severe poisoning. Such patients usually have acute toxicity, and attempted suicide is more often the reason for the emergency | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Anticuerpos antidigoxina. | |
| 650 | 4 | |a Chronic toxicity. | |
| 650 | 4 | |a Digoxin antibodies. | |
| 650 | 4 | |a Digoxin. | |
| 650 | 4 | |a Digoxina. | |
| 650 | 4 | |a Intoxicaciones. | |
| 650 | 4 | |a Intoxicación crónica. | |
| 650 | 4 | |a Poisoning. | |
| 650 | 7 | |a Antidotes |2 NLM | |
| 650 | 7 | |a Digoxin |2 NLM | |
| 650 | 7 | |a 73K4184T59 |2 NLM | |
| 700 | 1 | |a Martínez Baladrón, Andrea |e verfasserin |4 aut | |
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| 700 | 1 | |a Callado, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Lobo Antuña, Victoria |e verfasserin |4 aut | |
| 700 | 1 | |a Puiguriguer, Jordi |e verfasserin |4 aut | |
| 700 | 1 | |a Fuentes, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Molina Samper, Valle |e verfasserin |4 aut | |
| 700 | 1 | |a Caballero-Bermejo, Antonio F |e verfasserin |4 aut | |
| 700 | 1 | |a Vert, Susana |e verfasserin |4 aut | |
| 700 | 1 | |a Ruíz-Ruíz, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Guijarro Eguinoa, F Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Martín-Pérez, Beatriz |e verfasserin |4 aut | |
| 700 | 1 | |a Olmos, Samuel |e verfasserin |4 aut | |
| 700 | 1 | |a Burillo-Putze, Guillermo |e verfasserin |4 aut | |
| 700 | 1 | |a Maza Vera, María Teresa |e verfasserin |4 aut | |
| 700 | 1 | |a Pallàs, Oriol |e verfasserin |4 aut | |
| 700 | 1 | |a Climent, Benjamín |e verfasserin |4 aut | |
| 700 | 1 | |a Igartua Astibia, Maider |e verfasserin |4 aut | |
| 700 | 1 | |a Gutiérrez, Edith |e verfasserin |4 aut | |
| 700 | 1 | |a Nogué, Santiago |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrer Dufol, Ana |e verfasserin |4 aut | |
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