Abstract：
BACKGROUND: Gamma-hydroxybutyrate (GHB) use is associated with high risk of accidental overdose. This study examined the pre-hospital circumstances, demographic characteristics and clinical outcomes of analytically confirmed GHB emergency department (ED) presentations in Western Australia (WA).
METHODS: This case series was conducted across three WA EDs involved in the Emerging Drugs Network of Australia, from April 2020 to July 2022. Patient demographics, pre-hospital drug exposure circumstances and ED presentation and outcome characteristics were collected from ambulance and hospital medical records of GHB-confirmed cases.
RESULTS: GHB was detected in 45 ED presentations. The median age was 34 years and 53.3% (n = 24) were female. Most patients arrived at the ED by ambulance (n = 37, 85.7%) and required immediate emergency care (Australasian Triage Score 1 or 2 = 97.8%). One-third of patients were admitted to intensive care (n = 14, 31.1%). Methylamphetamine was co-detected in 37 (82.2%) GHB-confirmed cases. Reduced conscious state was indicated by first recorded Glasgow Coma Scale of ≤8 (n = 29, 64.4%) and observations of patients becoming, or being found, \'unresponsive\' and \'unconscious\' in various pre-hospital settings (n = 28, 62.2%). \'Agitated\' and/or \'erratic\' mental state and behavioural observations were recorded in 20 (44.4%) cases.
CONCLUSIONS: Analytically verified data from ED presentations with acute toxicity provides an objective information source on drug use trends and emerging public health threats. In our study, patients presenting to WA EDs with GHB intoxication were acutely unwell, often requiring intensive care treatment. The unexpectedly high proportion of female GHB intoxications and methylamphetamine co-ingestion warrants further exploration.
METHODS: This case series was conducted across three WA EDs involved in the Emerging Drugs Network of Australia, from April 2020 to July 2022. Patient demographics, pre-hospital drug exposure circumstances and ED presentation and outcome characteristics were collected from ambulance and hospital medical records of GHB-confirmed cases.
RESULTS: GHB was detected in 45 ED presentations. The median age was 34 years and 53.3% (n = 24) were female. Most patients arrived at the ED by ambulance (n = 37, 85.7%) and required immediate emergency care (Australasian Triage Score 1 or 2 = 97.8%). One-third of patients were admitted to intensive care (n = 14, 31.1%). Methylamphetamine was co-detected in 37 (82.2%) GHB-confirmed cases. Reduced conscious state was indicated by first recorded Glasgow Coma Scale of ≤8 (n = 29, 64.4%) and observations of patients becoming, or being found, \'unresponsive\' and \'unconscious\' in various pre-hospital settings (n = 28, 62.2%). \'Agitated\' and/or \'erratic\' mental state and behavioural observations were recorded in 20 (44.4%) cases.
CONCLUSIONS: Analytically verified data from ED presentations with acute toxicity provides an objective information source on drug use trends and emerging public health threats. In our study, patients presenting to WA EDs with GHB intoxication were acutely unwell, often requiring intensive care treatment. The unexpectedly high proportion of female GHB intoxications and methylamphetamine co-ingestion warrants further exploration.
摘要：
背景：使用γ-羟基丁酸酯（GHB）与意外过量的高风险相关。这项研究检查了院前情况，西澳大利亚州（WA）经分析确认的GHB急诊科（ED）报告的人口统计学特征和临床结果。
方法：本病例系列是针对参与澳大利亚新兴药物网络的三个WAED进行的，从2020年4月到2022年7月。患者人口统计学，从GHB确诊病例的救护车和医院医疗记录中收集院前药物暴露情况以及ED表现和结局特征.
结果：在45个ED演示文稿中检测到GHB。中位年龄为34岁，53.3%(n=24)为女性。大多数患者通过救护车到达ED（n=37，85.7％）并需要立即紧急护理（澳大利亚分类评分1或2=97.8％）。三分之一的患者接受了重症监护（n=14，31.1％）。在37例（82.2％）GHB确诊病例中同时检测到甲基苯丙胺。首次记录的格拉斯哥昏迷评分≤8（n=29，64.4％）和患者的观察结果表明意识状态降低，或者被发现，在各种院前环境中\'无反应\'和\'无意识\'（n=28，62.2％）。在20例（44.4％）中记录了“躁动”和/或“不稳定”的精神状态和行为观察。
结论：急性毒性ED报告的分析验证数据提供了关于药物使用趋势和新出现的公共卫生威胁的客观信息来源。在我们的研究中,出现GHB中毒的WAED患者严重不适，通常需要重症监护治疗。女性GHB中毒和甲基苯丙胺共同摄入的比例出乎意料地高，值得进一步探索。
方法：本病例系列是针对参与澳大利亚新兴药物网络的三个WAED进行的，从2020年4月到2022年7月。患者人口统计学，从GHB确诊病例的救护车和医院医疗记录中收集院前药物暴露情况以及ED表现和结局特征.
结果：在45个ED演示文稿中检测到GHB。中位年龄为34岁，53.3%(n=24)为女性。大多数患者通过救护车到达ED（n=37，85.7％）并需要立即紧急护理（澳大利亚分类评分1或2=97.8％）。三分之一的患者接受了重症监护（n=14，31.1％）。在37例（82.2％）GHB确诊病例中同时检测到甲基苯丙胺。首次记录的格拉斯哥昏迷评分≤8（n=29，64.4％）和患者的观察结果表明意识状态降低，或者被发现，在各种院前环境中\'无反应\'和\'无意识\'（n=28，62.2％）。在20例（44.4％）中记录了“躁动”和/或“不稳定”的精神状态和行为观察。
结论：急性毒性ED报告的分析验证数据提供了关于药物使用趋势和新出现的公共卫生威胁的客观信息来源。在我们的研究中,出现GHB中毒的WAED患者严重不适，通常需要重症监护治疗。女性GHB中毒和甲基苯丙胺共同摄入的比例出乎意料地高，值得进一步探索。
