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Acta Medica Colombiana

Print version ISSN 0120-2448

Abstract

JIMENEZ-OSPINA, LAURA; ZAPATA-OSPINA, JUAN PABLO; PINEDA-ALVAREZ, MATEO  and  QUINTERO-AGUIRRE, JULIANA. Characteristics and complications of acute cocaine intoxication. A cross-sectional study in an emergency room in Colombia. Acta Med Colomb [online]. 2022, vol.47, n.1, pp.22-30.  Epub May 06, 2022. ISSN 0120-2448.  https://doi.org/10.36104/amc.2022.2256.

Introduction:

the use of cocaine has increased, and, with it, the number of emergency room visits and hospitalizations due to acute intoxication. The objective was to describe the characteristics and complications of patients with cocaine intoxication who were seen in the emergency room of a tertiary care hospital in Colombia.

Materials and methods:

a cross-sectional study. Patients seen from 2016 to 2019 with cocaine intoxication, according to the medical chart and a positive cocaine test, and with no underlying diseases which would directly affect survival, were included. The sociodemographic and clinical characteristic were described, and the mortality and prevalence of complications were estimated.

Results:

a total of 159 patients were included, mostly males, with a low educational level and a median age of 31 years. The mortality was 3.8%. The prevalence of acute kidney injury (AKI) was 29.6% (95%CI 22.6 - 37.3%), 8.8% (95%CI 4.3 - 14.3%) for acute liver failure (ALF), 4.4% (95%CI 1.8 - 8.9%) for acute myocardial infarction (AMI) and 4.4% (95% CI 1.8-8.9%) for cerebrovascular accident (CVA). Elevated creatine phosphokinase (CPK) levels were found to be greater than 1,000 in 80% of patients with AKI, 100% of those with ALF, and 50% of those with CVA.

Conclusion:

acute cocaine intoxication causes multiple organ dysfunction, mainly of the kidneys and liver, which may be due to direct injury and possibly also due to muscle damage reflected in the elevated CPK. This could indicate the need for strict monitoring of this enzyme and research of its use as a prognostic variable. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2256).

Keywords : cocaine; cocaine-related disorders/complications; acute kidney injury; drug or substance-induced liver disease; rhabdomyolysis.

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