The Role of Premorbid Background in Tanatogenesis of Acute Poisonings with Psychoactive Drugs in Gerontological Patients

Background Human aging is a universal and regular process characterized by uneven and steady progression, inevitably affecting to some extent all levels of biological organization. In the structure of acute exotoxicosis, patients of gerontological age range from 10.3 to 12.9%. After 60, with an incr...

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Main Authors: K. K. Ilyashenko, G. N. Sukhodolova, A. Y. Simonova, M. M. Potskhveriya, A. Y. Kluyev, L. N. Zimina, M. V. Barinova
Format: Article
Language:Russian
Published: Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department 2018-11-01
Series:Неотложная медицинская помощь
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Online Access:https://www.jnmp.ru/jour/article/view/500
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author K. K. Ilyashenko
G. N. Sukhodolova
A. Y. Simonova
M. M. Potskhveriya
A. Y. Kluyev
L. N. Zimina
M. V. Barinova
author_facet K. K. Ilyashenko
G. N. Sukhodolova
A. Y. Simonova
M. M. Potskhveriya
A. Y. Kluyev
L. N. Zimina
M. V. Barinova
author_sort K. K. Ilyashenko
collection DOAJ
description Background Human aging is a universal and regular process characterized by uneven and steady progression, inevitably affecting to some extent all levels of biological organization. In the structure of acute exotoxicosis, patients of gerontological age range from 10.3 to 12.9%. After 60, with an increase of years, there is a growth of mortality rate from 9.8% in elderly patients to 25.5% in long-livers. A certain role in its genesis is played by the premorbid background, i.e. somatic diseases preceding and accompanying acute exotoxicosis.Aim of study To identify the role of concomitant diseases in the course and outcome of acute poisoning by psychoactive drugs in patients over 60. MATErIALS AnD METhODS We retrospectively analyzed hospital records of 99 patients aged 60 to 90 years who died from poisoning with psychoactive drugs at the N.V. Sklifosovsky Research Institute for Emergency Medicine in 2013–2016, as well as their autopsy, forensic and histological research data.Results In gerontological patients with acute poisoning with psychoactive drugs, the main premorbid background (100%) is atherosclerotic lesion of the heart and vessels of different degree and extent. In case of lethal outcomes, in toxicogenic stage of poisoning on primary electrocardiograms, myocardial ischemia was revealed in 76.9% of cases, heart rhythm disturbances were detected in all patients, most often in the form of supraventricular extrasystoles (38.4%) and atrial fibrillation (23.1%). In the deceased patients during the somatogenic stage of poisoning, cardiac conduction disorders (31.3%) prevailed. Concomitant chronic lesions of the bronchopulmonary system, including terminal bronchi, contributed to the development of hypostatic pneumonia and its long, migratory course. In 50% of cases, large and small droplet fatty liver disease was detected, which could have a negative effect on the course of poisoning, altering biotransformation of toxicants.Conclusion Atherosclerotic lesion of the heart and vessels, as well as chronic bronchopulmonary disease and fatty liver disease are the main premorbid background factors, which have a negative effect on the course and outcome of acute poisoning with psychoactive drugs.
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spelling doaj-art-8a85974dfd6f467997e75b3526d63e542025-08-20T03:56:37ZrusSklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentНеотложная медицинская помощь2223-90222541-80172018-11-017320220810.23934/2223-9022-2018-7-3-202-208451The Role of Premorbid Background in Tanatogenesis of Acute Poisonings with Psychoactive Drugs in Gerontological PatientsK. K. Ilyashenko0G. N. Sukhodolova1A. Y. Simonova2M. M. Potskhveriya3A. Y. Kluyev4L. N. Zimina5M. V. Barinova6N.V. Sklifosovsky research Institute for Emergency Medicine of the Moscow healthcare DepartmentN.V. Sklifosovsky research Institute for Emergency Medicine of the Moscow healthcare DepartmentN.V. Sklifosovsky research Institute for Emergency Medicine of the Moscow healthcare DepartmentN.V. Sklifosovsky research Institute for Emergency Medicine of the Moscow healthcare DepartmentN.V. Sklifosovsky research Institute for Emergency Medicine of the Moscow healthcare DepartmentN.V. Sklifosovsky research Institute for Emergency Medicine of the Moscow healthcare DepartmentN.V. Sklifosovsky research Institute for Emergency Medicine of the Moscow healthcare DepartmentBackground Human aging is a universal and regular process characterized by uneven and steady progression, inevitably affecting to some extent all levels of biological organization. In the structure of acute exotoxicosis, patients of gerontological age range from 10.3 to 12.9%. After 60, with an increase of years, there is a growth of mortality rate from 9.8% in elderly patients to 25.5% in long-livers. A certain role in its genesis is played by the premorbid background, i.e. somatic diseases preceding and accompanying acute exotoxicosis.Aim of study To identify the role of concomitant diseases in the course and outcome of acute poisoning by psychoactive drugs in patients over 60. MATErIALS AnD METhODS We retrospectively analyzed hospital records of 99 patients aged 60 to 90 years who died from poisoning with psychoactive drugs at the N.V. Sklifosovsky Research Institute for Emergency Medicine in 2013–2016, as well as their autopsy, forensic and histological research data.Results In gerontological patients with acute poisoning with psychoactive drugs, the main premorbid background (100%) is atherosclerotic lesion of the heart and vessels of different degree and extent. In case of lethal outcomes, in toxicogenic stage of poisoning on primary electrocardiograms, myocardial ischemia was revealed in 76.9% of cases, heart rhythm disturbances were detected in all patients, most often in the form of supraventricular extrasystoles (38.4%) and atrial fibrillation (23.1%). In the deceased patients during the somatogenic stage of poisoning, cardiac conduction disorders (31.3%) prevailed. Concomitant chronic lesions of the bronchopulmonary system, including terminal bronchi, contributed to the development of hypostatic pneumonia and its long, migratory course. In 50% of cases, large and small droplet fatty liver disease was detected, which could have a negative effect on the course of poisoning, altering biotransformation of toxicants.Conclusion Atherosclerotic lesion of the heart and vessels, as well as chronic bronchopulmonary disease and fatty liver disease are the main premorbid background factors, which have a negative effect on the course and outcome of acute poisoning with psychoactive drugs.https://www.jnmp.ru/jour/article/view/500acute poisoningpsychoactive drugsgerontological patientspremorbid background
spellingShingle K. K. Ilyashenko
G. N. Sukhodolova
A. Y. Simonova
M. M. Potskhveriya
A. Y. Kluyev
L. N. Zimina
M. V. Barinova
The Role of Premorbid Background in Tanatogenesis of Acute Poisonings with Psychoactive Drugs in Gerontological Patients
Неотложная медицинская помощь
acute poisoning
psychoactive drugs
gerontological patients
premorbid background
title The Role of Premorbid Background in Tanatogenesis of Acute Poisonings with Psychoactive Drugs in Gerontological Patients
title_full The Role of Premorbid Background in Tanatogenesis of Acute Poisonings with Psychoactive Drugs in Gerontological Patients
title_fullStr The Role of Premorbid Background in Tanatogenesis of Acute Poisonings with Psychoactive Drugs in Gerontological Patients
title_full_unstemmed The Role of Premorbid Background in Tanatogenesis of Acute Poisonings with Psychoactive Drugs in Gerontological Patients
title_short The Role of Premorbid Background in Tanatogenesis of Acute Poisonings with Psychoactive Drugs in Gerontological Patients
title_sort role of premorbid background in tanatogenesis of acute poisonings with psychoactive drugs in gerontological patients
topic acute poisoning
psychoactive drugs
gerontological patients
premorbid background
url https://www.jnmp.ru/jour/article/view/500
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