Predictors of mortality in illicit drug users involving Novel Psychoactive Substances (NPS) and multiple substances have not been elucidated. We aimed to define predictors of mortality in the NPS endemic era’s illicit drug users to strengthen patient care in emergency treatment. This was a retrospective study. LC-MS/MS-confirmed positive illicit drug users who visited the emergency departments (ED) of six medical systems were enrolled. Demographic information, physical examinations, and laboratory data were abstracted for mortality analysis. There were 16 fatalities in 355 enrolled patients. The most frequently used illicit drugs were amphetamines, followed by opioids, cathinones, and ketamine. The most frequently detected cathinones among the 16 synthetic cathinones were eutylone, followed by mephedrone. The combined use of cathinones and ketamine was most commonly observed in our results. Univariate analysis revealed that the mortality patients were older, with deep coma, faster heart rate and respiratory rate, lower blood pressures and O2 room air saturation, more seizures, abnormal breath sounds, and had urine incontinence compared to the survivor patients. The mortality patients also had acute kidney injury, higher potassium, blood sugar, liver function test, and lactate level. The results of multiple logistic regression demonstrated that SBP < 90 mmHg, dyspnea, blood sugar > 140 mg/dl, and HCO3 < 20.6 mmHg were independent predictors of in-hospital mortality. Regardless of the pattern of the use of illicit drugs, the predictors allow for risk stratification and determining the optimal treatment.
Objective: Hyperbaric oxygen (HBO2) is used in several clinical and research fields. This study aimed to analyze the 100 most-cited hyperbaric-related publications of the past 10 years to understand the trends in HBO2 research. Methods: This was a literature review. All publication and citation data were retrieved from the Scopus database. Publications with “hyperbaric oxygen,” “hyperbaric oxygenation,” “HBO,” and “HBOT” in the title, abstract, or keywords published between January 01, 2011, and December 31, 2020, were enrolled. The 100 most-cited HBO2-focused publications were identified, and their publication title, authors’ nationality, publication journal, year, type (original or review), and application field were recorded and analyzed using descriptive statistics. Linear regression was used to evaluate the trends in publication numbers. Results: A total of 6,517 publications were enrolled. The annual rate of increase was 4.56 per year (p-value = 0.13, 95% CI: -1.62 to 10.74). The total, average, median and mode of citations were 67,726, 10.4, 4, and 0, respectively. The 100 most-cited HBO2-focused publications accounted for 1.5% (100/6,517) of all publications and 8.1% (5509/67,726) of the total number of times cited. The most cited publications originated from 17 countries and were published in 65 journals, led by the Cochrane Database of Systematic Reviews. Conclusions: The annual number of HBO2 publications was stationary. The citation numbers showed a skewed distribution. The United States was the leading country in HBO2 research. Of 26 application fields, traumatic brain injury, stroke, and diabetic foot were the leading three fields.
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