Summary

Seizures secondary to illegal drug use treated in hospital Emergency Departments: a multicenter national study

Indira Vega Sánchez¹, Guillermo Burillo-Putze^1,2,3, Dima Ibrahim-Achi^1,2, Miguel Galicia Paredes^3,4, August Supervía⁵, Jordi Puiguriguer Ferrando⁶, M.ª de los Ángeles López Hernández², Sebastián Matos Castro^3,7, Òscar Miró^3,4, en representación de la Red de Estudio de Drogas en Urgencias Hospitalarias en España (REDUrHE)

Affiliation of the authors

¹Departamento de Medicina Física y Farmacología, Universidad de La Laguna, Tenerife, Spain. ²Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, Spain. ³Red de Investigación de drogas en Atención Primaria (RIAPAD). ⁴Servicio de Urgencias, Hospital Clínic, Barcelona, Spain. ⁵Servicio de Urgencias, Hospital del Mar, Barcelona, Spain.⁶Unidad de Toxicología Clínica, Hospital Son Espases, Palma de Mallorca, Spain. ⁷Universidad Europea de Canarias, Tenerife, Spain.

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Vega Sánchez I, Burillo-Putze G, Ibrahim-Achi D, Galicia Paredes M, Supervía A, Puiguriguer Ferrando J, López Hernández MA, Matos Castro S, Miró O, en representación de la Red de Estudio de Drogas en Urgencias Hospitalarias en España (REDUrHE). Seizures secondary to illegal drug use treated in hospital Emergency Departments: a multicenter national study. Rev Esp Urg Emerg. 2022;1:75–80

Summary

OBJECTIVES. To estimate the incidence of seizures due to poisoning by street drugs in Spain and to describe the demographic, toxicologic, and clinical characteristics of the events.
METHODS. Prospective multicenter analysis of data from the registry of the Spanish Research Network on Drugs in Hospital Emergency Departments (REDUrHE), a 24-month project in 2017 to 2019 in 11 Spanish hospital emergency departments. The patients were treated for seizures after poisoning due to street drug use.
RESULTS. A total of 243 patients (in 5.4% of the cases registered) had seizures. Seventy-nine percent were men. No statistically significant differences between the sexes were found. A significantly higher incidence of seizures was observed only in the group of patients poisoned by unidentified substances. Patients without seizures had more palpitations (in 17.1% vs in 5.3% of those with seizures), chest pain (9.4% vs 2.1%, respectively), and cerebellar signs and anxiety (26.5% vs 10.7%) (P<.001, all comparisons). Patients with seizures differed with respect to need for orotracheal intubation (in 3.3% vs 1.6% of those without seizures; P=.038), positive urine tests for drugs (91.8 % vs 75.7%; P<.001), and intensive care unit (ICU) admission (5.3% vs 1.8%; P<.001). Length of stay in the emergency department and mortality did not differ between patients with and without seizures. The following events were over twice as likely in patients who had seizures: orotracheal intubation, odds ratio (OR), 2.161 (95% CI, 1.025-4.54); use of an unidentified substance, OR, 2.222 (95% CI, 1.457-3.389); and ICU admission, OR, 2.161 (95% CI, 1.025-4.554). Coingestion of alcohol was not related to having seizures: OR, 0.264; 95% CI, 0.097-0.715).
CONCLUSION. A higher risk of seizure was not associated with any particular known street drug, although the risk increased when an unknown substance had been used.