Evidence mapPaperPMID 33975395Full record

ArticleJournal of Korean medical science2021

Changes in Diagnosis of Poisoning in Patients in the Emergency Room Using Systematic Toxicological Analysis with the National Forensic Service.

Je Seop Lee, Yong Sung Cha, Seonghoon Yeon, Tae Youn Kim, Yoonsuk Lee, Jin Geul Choi, Kyoung Chul Cha, Kang Hyun Lee, Hyun Kim

Open access · goldAbstract read
In one paragraph

Article in Journal of Korean medical science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Je Seop LeeDepartment of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.ORCID https://orcid.org/0000-0003-1865-0792
Yong Sung ChaDepartment of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.ORCID https://orcid.org/0000-0001-9897-4273
Seonghoon YeonDrug and Forensic Toxicology Division, National Forensic Service, Wonju, Korea.ORCID https://orcid.org/0000-0002-5510-5446
Tae Youn KimDepartment of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.ORCID https://orcid.org/0000-0003-0353-5345
Yoonsuk LeeDepartment of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.ORCID https://orcid.org/0000-0003-0404-7255
Jin Geul ChoiDepartment of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.ORCID https://orcid.org/0000-0002-1294-6093
Kyoung Chul ChaDepartment of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.ORCID https://orcid.org/0000-0003-1818-2466
Kang Hyun LeeDepartment of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.ORCID https://orcid.org/0000-0001-9664-9186
Hyun KimDepartment of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. khyun@yonsei.ac.kr.ORCID https://orcid.org/0000-0002-1696-9401
Yonsei University · KRNational Forensic Institute · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is difficult to diagnose patients with poisoning and determine the causative agent in the emergency room. Usually, the diagnosis of such patients is based on their medical history and physical examination findings. We aimed to confirm clinical diagnoses using systematic toxicological analysis (STA) and investigate changes in the diagnosis of poisoning.

methodsThe Intoxication Analysis Service was launched in June 2017 at our hospital with the National Forensic Service to diagnose intoxication and identify toxic substances by conducting STA. Data were collected and compared between two time periods: before and after the initiation of the project, i.e., from June 2014 to May 2017 and from June 2017 to May 2020.

resultsA total of 492 and 588 patients were enrolled before and after the service, respectively. Among the 588 after-service patients, 446 underwent STA. Among the 492 before-service patients, 69.9% were diagnosed clinically, whereas the causative agent could not be identified in 35 patients. After starting the service, a diagnosis was confirmed in 84.4% of patients by performing a hospital-available toxicological analysis or STA. Among patients diagnosed with poisoning by toxins identified based on history taking, only 83.6% matched the STA results, whereas 8.4% did not report any toxin, including known substances. The substance that the emergency physician suspected after a physical examination was accurate in 49.3% of cases, and 12% of cases were not actually poisoned. In 13.4% of patients who visited the emergency room owing to poisoning of unknown cause, poisoning could be excluded after STA. Poisoning was determined to be the cause of altered mental status in 31.5% of patients for whom the cause could not be determined in the emergency room.

conclusionA diagnosis may change depending on the STA results of intoxicated patients. Therefore, appropriate STA can increase the accuracy of diagnosis and help in making treatment decisions.

Indexed as

Emergency Service, HospitalForensic ToxicologyForensic MedicineHumansPoisoningForensic ToxicologyLaboratory DiagnosisPoisoningToxicology

Identifiers

PMID33975395
PMCPMC8111044
OpenAlexW3155574773

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.