TY - JOUR PY - 2020// TI - Diagnostic accuracy for drug detection using liquid chromatography/mass spectroscopy in overdose patients JO - Acute medicine and surgery A1 - Yagihashi, Gen A1 - Tarui, Takehiko A1 - Miyagi, Hiroyuki A1 - Ohnishi, Hiroaki A1 - Watanabe, Takashi A1 - Yamaguchi, Yoshihiro SP - EP - VL - 7 IS - 1 N2 - AIM:Information about the causative drugs is essential for appropriate treatment for drug overdose, but patients sometimes cannotprovide information about overdosed drugs owing to disturbed consciousness or an unwillingness to cooperate with treatment. Thepurpose of this study was to decide whether liquid chromatography/mass spectroscopy (LC/MS) is useful as a detection method foroverdosed drugs.

METHODS:Overdose patients (n=279) treated in our facility were retrospectively studied. Specimens from gastric lavage, bloodserum, and urine were tested using LC/MS. The matching rates between drugs overdosed and those detected by LC/MS were evalu-ated; LC/MS and Triage DOARwere also compared. Data are shown as means.

RESULTS:Patients overdosed on 3.2 kinds of drugs and were transferred to our hospital 4.6 h after. Overall 3.5 kinds of drugs weredetected by LC/MS, and 2.4, 1.9, and 2.2 kinds were from the stomach, blood, and urine, respectively. Matching rate among theingested drugs (kinds of drugs matched/ones ingested) was the highest in the gastric samples (0.56), and the lowest in the urine sam-ples (0.46) (P<0.01). In addition, the matching rates among the detected drugs (kinds of drugs matched/ones detected) were as highas 0.74 and 0.78 in the gastric and blood samples, respectively. Comparing the sensitivity and specificity of detection of benzodi-azepines and tricyclic antidepressants between LC/MS and Triage DOAR, we found that these two methods were comparable.

CONCLUSION:Liquid chromatography/mass spectroscopy was proven to be an effective method to detect overdosed drugs, espe-cially when there was not enough information about the drugs ingested.Key words:Detection, drug overdose, liquid chromatography, mass spectroscopy, poisoning, screening, toxicology

Language: en

LA - en SN - 2052-8817 UR - http://dx.doi.org/10.1002/ams2.487 ID - ref1 ER -