Krawczyk et al reported factors predictive of a death following a drug overdose. These can help to identify a patient who may require more aggressive management. The authors are from Johns Hopkins University and the Maryland Department of Health.
Patient selection: high-risk Emergency Department patient with substance abuse
NOTE: The paper is occurring during a national opioid epidemic, so the predictors tent to reflect opioid exposure.
Predictors of a fatal overdose:
(1) mixed substance abuse disorder (opioid plus another substance)
(2) >= 3 previous nonfatal overdose episodes
(3) a previous overdose episode involving heroin
where:
• The combination of an opiate with alcohol or sedative can result in respiratory depression.
• Fentanyl or other synthetic opioids are potent and often involved in opiate abuse.
The predictors demonstrate the need to intervene after an overdose episode in order to prevent another which may be fatal.
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