Immediate and 30 days mortality in digoxin poisoning cases attended in the Hospital Emergency Services of Catalonia, Spain
Supervía Caparrós A, Salgado García E, Calpe Perarnau X, Galicia Paredes M, García Gibert L, Córdoba Ruiz F, Clemente Rodríguez C, Nogué Xarau S
Affiliation of the authors
Emergency Department, Hospital Universitario del Mar, Barcelona, Spain. Functional Toxicology Unit, Hospital Universitario del Mar, Barcelona, Spain. Universitat Autònoma de Barcelona, Spain. Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain. SoCMUE Toxicology Working Group (SoCMUETox), Spain. Emergency Department, Hospital Clínic de Barcelona, Spain. Toxicology Unit, Hospital Clínic de Barcelona, Spain. Universitat de Barcelona, Spain. Emergency Department, Consorci Sanitari Parc Taulí, Sabadell, Barcelona, Spain. Emergency Department, Hospital Moises Broggi Sant Joan Despí, Barcelona, Spain.
Supervía Caparrós A, Salgado García E, Calpe Perarnau X, Galicia Paredes M, García Gibert L, Córdoba Ruiz F, et al. Immediate and 30 days mortality in digoxin poisoning cases attended in the Hospital Emergency Services of Catalonia, Spain. Emergencias. 2019;31:39-42
Summary
Background and objective.
Digoxin poisoning is a frequent reason for seeking emergency care. This study aimed to assess mortality related to digoxin poisoning.
Methods.
Descriptive observational study of digoxin poisonings attended in the emergency departments of 4 hospi-tals in Catalonia from 2013 through 2015. We gathered data relevant to the poisonings and recorded immediate and 30-day mortality. Factors possibly related to mortality were explored.
Results.
A total of 171 digoxin poisonings were attended. Seven (4.1%) were acute and 164 (95.9%) were chronic. The immediate and 30-day mortality rates were 6.4% and 13.4%, respectively. Bivariate analysis did not identify fac-tors related to immediate mortality. However, the variables more often associated with 30-day mortality in this analy-sis were acute poisoning (after which 13% died vs 2.7% of those with chronic poisoning, P=.05), suicide attempts (8.7% of whom died vs 0.7%, P=.048), more compromised renal function (21.7% vs 9.5%, P=.037), fewer neurologic symptoms (4.3% vs 17.8% with more symptoms, P=.005), higher mean digoxin concentrations (4.7 mg/dL in those who died vs 3.7 mg/dL, P=.027), and a lower Barthel index (mean [SD] 49.1 [33.4] in those who died vs 70.3 [28.5]; P=.006). Logistic regression analysis identified serum digoxin concentration to be independently associated with im-mediate mortality. A lower Barthel index was associated with 30-day mortality.
Conclusions.
Immediate mortality is related to a high digoxin concentration in serum, and 30-day mortality to a low Barthel index.
