| Summary: | 碩士 === 國立陽明大學 === 環境與職業衛生研究所 === 97 === Abstract
Objectives:
Use of new illicit drugs, especially ketamine, is rapidly increasing in Taiwan in recent years. Drug abuse related poisonings or accidents are also increasing (e.g. ketamine related interstitial cystitis); however the profile of such events remains unclear. The aim of this study was to understand the baseline characteristics and clinical profiles of patients who were hospitalized because of ketamine abuse related illnessses.
Materials and Methods
We identified patients who visited the emergency department of Taipei Veterans General Hospital (VGH) because of ketamine abuse related illnesses and who were tested positive for ketamine between 2000 and 2008 using the database from the Taipei VGH clinical toxicology laboratory. We also identified patients who were hospitalized to Taipei VGH because of ketamine related interstitial cystitis during the same period by reviewing the medical records of patients with the ICD code 595.X. Moreover, we collected the data of patients who visited the emergency department of China Medical University Hospital (CMUH) because of ketamine abuse related illnesses from 2006 through 2008 by employing chart review. All data were then analyzed to better understand the characteristics and disease pattern among patients who sought medical care because of ketamine related illnesses.
Results:
During the study period, there were a total of 114 patients who were tested positive for ketamine in Taipei VGH. In addition, there were 13 patients with ketamine related interstitial cystitis who did not have a urine confirmation test. The case number of ketamine abuse increased gradually by calendar year, and the trend was significantly correlated with the annual amount of seized ketamine (R= 0.729). Ketamine abusers mainly involved younger population (63.4% below 25 years old); and most patients (55.5%) sought medical care because of diseases other than suicide or unintentional poisoning. Common clinical manifestations of ketamine abusers included genitourinary tract symptoms (16.5%), psychiatric symptoms (23.2%), and neurological symptoms (26.8%). Seventy-nine patients were hospitalized; three patients died and 52 patients developed sequelae.
Compared to patients with non-ketamine related interstitial cystitis, patients with ketamine related interstitial cystitis were younger. The two groups of patients were also different in many characteritiscs, including pattern of hospitalization, severity, sequelae, platelet count, and total amount of urine protein.
During the 3-year study period, there were 37 cases of ketamine related illness identified from CMU Hospital. The case number also increased gradually by time. While the clinical manifestations of patients from CMU Hospital were largely similar to those of patients from Taipei VGH, the prevalence of various manifestations were different between the two groups of patients. Furthermore, the two groups of patients were quite different in many baseline characteristics.
Conclusions:
The study findings showed that the number of ketamine abusers was increasing and ketamine related illnesses were also increasing by calendar time in Taiwan. Ketamine related illnesses mainly involved people of younger age, unmarried status, and high school education level. Patients with ketamine related illness frequently sought medical care through emergency department and manifested genitourinary tract symptoms, psychiatric symptoms, and neurological symptoms. Ketamine abusers were also frequently accompanied by abnormalities in urinalysis and liver enzymes, and might develop serious sequelae as well. The above abnormalities/sequelae probably represent specific patterns of ketamine poisoning, a finding that deserves more emphasis and future investigation. To reduce the hazards associated with ketamine abuse, national policy on controlling ketamine abuse and relevant preventive strategies should be refined.
Keywords: accident, drug abuse, ketamine, interstitial cystitis
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