Læknablaðið - 01.10.2014, Blaðsíða 23

LÆKNAblaðið 2014/100 519
eðlilegt hjá fámennri þjóð. Styrkleikar rannsóknarinnar eru þeir að
hún nær til flestra sem fengu lífshættulega fylgikvilla í tengslum við
notkun vímuefna í æð og þörfnuðust gjörgæsluinnlagnar en erfitt
er að fela slíka neyslu við þær aðstæður og eftirfylgni þeirra var
nákvæm. Einnig náði hún til allra niðurstaðna réttarefnafræðilegra
rannsókna á dauðsföllum fólks sem vitað er um með tengsl við notk-
un vímuefna í æð á rannsóknartímabilinu.
Ályktun
Um 1% innlagna á gjörgæsludeildir Landspítala er vegna fylgikvilla
af neyslu fíkniefna í æð. Þetta er ungur sjúklingahópur sem oftast
leggst inn vegna alvarlegra eitrana eða sýkinga og er með mjög
skertar lífslíkur miðað við sama aldurshóp, en 35% hans voru
látin innan 5 ára. Niðurstöður réttarefnafræðilegra rannsókna
leiða í ljós 4,1 andlát/105/ár vegna neyslu vímuefna í æð sem
gefur til kynna að umfang vandans sé sambærilegt og á öðrum
Norðurlöndum. Áhyggjuefni er hve algengt er að nota uppleyst
lyfseðilsskyld lyf sem vímuefni til inngjafar í æð.
ENGLISH SUMMARY
introduction: Injecting drug abuse is a worldwide problem with serious
consequences for the individual and for society. The purpose of this
study was to gather information on the most serious complications of
injecting drug use from two perspectives, intensive care admissions and
forensic toxicology reports.
Material and methods: Firstly, intensive care admissions related to
injecting drug abuse during a five year period were reviewed for demog-
raphics, complications and 5 year survival. Secondly, information from
forensic toxicology reports regarding deaths amongst known injecting
drug abusers were gathered for the same period.
Results: A total of 57 patients with a history of active injecting drug use
were admitted to intensive care or approximately 1% of admissions,
most often for overdose (52%) or life threatening infections (39%).
Median age was 26, males were 66%. The most common substances
used were prescription drugs. Hospital mortality was 16% and five
year survival 65%. Average time from hospital discharge to death was
916±858 days. during the study period 38 deaths of individuals with a
history of injecting drugs were identified by forensic toxicology reports
or 4.1/105 population/year (age 15-59). Cause of death was most often
overdose (53%), usually from prescription opiates but multiple drug use
was common.
Discussion: The life expectancy of injecting drug abusers after inten-
sive care admission is substantially decreased, with 35% death rate
within five years. A widespread use of prescription drugs is of concern.
Injecting drug abuse seems to be a similar health problem in magnitude
in Iceland as in other Scandinavian countries.
key words: injecting drug abuse, ICU admission, prescription drugs, drug addict deaths, long term survival.
Correspondence: Kristinn Sigvaldason, krisig@landspitali.is
injecting drug abuse: Survival after intensive care admission and forensic toxicology reports at death
Kristinn Sigvaldason1, Thoroddur Ingvarsson1, Svava Thordardottir2, Jakob Kristinsson3, Sigurbergur Karason1,3
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