The associative factors of delayed-onset rhabdomyolysis in patients with doxylamine overdose

• Published in: The American journal of emergency medicine Vol. 29; no. 8; pp. 903 - 907
• Main Authors: Kim, Han Joon, MD, PhD, Oh, Sang Hoon, MD, Youn, Chun Song, MD, Wee, Jung Hee, MD, Kim, Ji Hoon, MD, Jeong, Won Jung, MD, Kim, Soo Hyun, MD, Jeong, Seung Hee, MPH, Park, Kyu Nam, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2011; Elsevier; Elsevier Limited
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antiemetics - poisoning; Biological and medical sciences; Cardiac arrhythmia; Chi-Square Distribution; Confidence intervals; Creatine Kinase - blood; Doxylamine - poisoning; Drug intoxications. Doping; Drug Overdose; Emergency; Emergency medical care; Family medical history; Female; Heart rate; Heart Rate - drug effects; Humans; Intensive care medicine; Male; Medical sciences; Odds Ratio; Overdose; Pharmacology. Drug treatments; Regression analysis; Retrospective Studies; Rhabdomyolysis - blood; Rhabdomyolysis - chemically induced; ROC Curve; Statistics, Nonparametric; Studies; Suicides & suicide attempts; Teaching hospitals; Time Factors; Korea; Human; Intensive care; Psychotropic; Overdosing; Hypnotic; Rhabdomyolysis; Antihistaminic; Antiallergic; Striated muscle disease; Doxylamine; Overdose; Antagonist; Sedative; H1 Histamine receptor; Antiemetic; Resuscitation
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2010.10.032

Abstract Objectives The aim of this study was to investigate the associative factors of rhabdomyolysis in patients with doxylamine overdose who had normal creatine phosphokinase levels at admission. Methods This study included 169 patients who visited the emergency department of a tertiary teaching hospital after doxylamine overdose between January 1, 1998, and March 31, 2009. Demographic information, clinical variables, and laboratory data were investigated for the associative factors of rhabdomyolysis. Results Thirty-five (21%) of the 169 patients developed rhabdomyolysis. Patients who developed rhabdomyolysis differed from those who did not in the amount of doxylamine ingested, sex, heart rate, initial value of serum creatinine, and alanine aminotransferase. In the multivariate regression analysis, the only reliable predictors of rhabdomyolysis were the amount of doxylamine ingested ( P = .004) and heart rate ( P < .001). Conclusion Observation and laboratory follow-up are required for patients with large reported ingestions or tachycardia on admission, even if their creatine phosphokinase levels were normal.