{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T01:18:30Z","timestamp":1770513510568,"version":"3.49.0"},"reference-count":22,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T00:00:00Z","timestamp":1657584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chang Gung Medical Foundatio"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>Predictors of mortality in illicit drug users involving Novel Psychoactive Substances (NPS) and multiple substances have not been elucidated. We aimed to define predictors of mortality in the NPS endemic era\u2019s illicit drug users to strengthen patient care in emergency treatment. This was a retrospective study. LC-MS\/MS-confirmed positive illicit drug users who visited the emergency departments (ED) of six medical systems were enrolled. Demographic information, physical examinations, and laboratory data were abstracted for mortality analysis. There were 16 fatalities in 355 enrolled patients. The most frequently used illicit drugs were amphetamines, followed by opioids, cathinones, and ketamine. The most frequently detected cathinones among the 16 synthetic cathinones were eutylone, followed by mephedrone. The combined use of cathinones and ketamine was most commonly observed in our results. Univariate analysis revealed that the mortality patients were older, with deep coma, faster heart rate and respiratory rate, lower blood pressures and O2 room air saturation, more seizures, abnormal breath sounds, and had urine incontinence compared to the survivor patients. The mortality patients also had acute kidney injury, higher potassium, blood sugar, liver function test, and lactate level. The results of multiple logistic regression demonstrated that SBP &lt; 90 mmHg, dyspnea, blood sugar &gt; 140 mg\/dl, and HCO3 &lt; 20.6 mmHg were independent predictors of in-hospital mortality. Regardless of the pattern of the use of illicit drugs, the predictors allow for risk stratification and determining the optimal treatment.<\/jats:p>","DOI":"10.3390\/toxics10070386","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T23:02:01Z","timestamp":1657666921000},"page":"386","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical Presentations and Predictors of In-Hospital Mortality in Illicit Drug Users in the New Psychoactive Substances (NPS) Endemic Era in Taiwan"],"prefix":"10.3390","volume":"10","author":[{"given":"Hsin-Tzu","family":"Yeh","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9353-026X","authenticated-orcid":false,"given":"Hsien-Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung-Wei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Emergency, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan"},{"name":"Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Te-I","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan"},{"name":"Forensic and Clinical Toxicology Center, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan"},{"name":"Institute of Forensic Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Chung","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan"},{"name":"Forensic and Clinical Toxicology Center, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiun-Hao","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, China Medical University Hospital, Hsinchu 300, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen-Chia","family":"Chen","sequence":"additional","affiliation":[{"name":"Emergency Department, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, National Yang-Ming Chiao Tung University, Taipei 11217, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0218-1944","authenticated-orcid":false,"given":"Yu-Jang","family":"Su","sequence":"additional","affiliation":[{"name":"Emergency Department, Mackay Memorial Hospital, Taipei 104, Taiwan"},{"name":"Poison Center, Mackay Memorial Hospital, Taipei 104, Taiwan"},{"name":"Department of Medicine, Mackay Medical College, New Taipei City 251, Taiwan"},{"name":"MacKay Junior College of Medicine, Nursing, and Management, New Taipei City 251, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi-Ying","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9613-115X","authenticated-orcid":false,"given":"Chih-Chuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"156","DOI":"10.3389\/fpsyt.2017.00156","article-title":"Synthetic Cathinone and Cannabinoid Designer Drugs Pose a Major Risk for Public Health","volume":"8","author":"Weinstein","year":"2017","journal-title":"Front. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1038\/npp.2015.260","article-title":"Abuse of New Psychoactive Substances: Threats and Solutions","volume":"41","author":"Baumann","year":"2016","journal-title":"Neuropsychopharmacology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.neuro.2020.03.015","article-title":"Use of new psychoactive substances to mimic prescription drugs: The trend in France","volume":"79","author":"Batisse","year":"2020","journal-title":"Neurotoxicology"},{"key":"ref_4","unstructured":"United Nations Office on Drugs and Crime (UNODC) (2021). World Drug Report: Stimulants, United Nations Office on Drugs and Crime."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1093\/oxfordjournals.pubmed.a024699","article-title":"Health care systems in transition. II. Taiwan, Part II. The current status of HIV-AIDS in Taiwan","volume":"20","author":"Chang","year":"1998","journal-title":"J. Public Health Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/YCO.0000000000000604","article-title":"New psychoactive substances in Taiwan: Challenges and strategies","volume":"33","author":"Feng","year":"2020","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.24966\/AAD-7276\/100023","article-title":"Psychiatric Profiles and Clinical Manifestations of Cathinone Users: Case Series of Analytically Confirmed Cathinone Use in Taiwan","volume":"6","author":"Chang","year":"2019","journal-title":"Addict. Addict. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1080\/15563650.2022.2038793","article-title":"Emergency department visits due to new psychoactive substances and other illicit drugs in Taiwan: Preliminary results of the Taiwan Emergency Department Drug Abuse Surveillance (TEDAS) project","volume":"60","author":"Lin","year":"2022","journal-title":"Clin. Toxicol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2045125320967197","DOI":"10.1177\/2045125320967197","article-title":"New psychoactive substances: A review and updates","volume":"10","author":"Shafi","year":"2020","journal-title":"Ther. Adv. Psychopharmacol."},{"key":"ref_10","first-page":"94","article-title":"Treatment of intoxication with new psychoactive substances and methamphetamine","volume":"38","author":"Pajonk","year":"2015","journal-title":"Med. Monatsschr. Pharm."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1111\/add.12484","article-title":"A critical first assessment of the new pre-market approval regime for new psychoactive substances (NPS) in New Zealand","volume":"109","author":"Wilkins","year":"2014","journal-title":"Addiction"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s13613-020-00762-9","article-title":"Management of pharmaceutical and recreational drug poisoning","volume":"10","author":"Oberlin","year":"2020","journal-title":"Ann. Intensive Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"867","DOI":"10.2471\/BLT.07.045120","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"85","author":"Altman","year":"2007","journal-title":"Bull. World Health Organ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"100016","DOI":"10.1016\/j.etdah.2021.100016","article-title":"Mortality involving New Psychoactive Substances across Europe, 2016\u20132017","volume":"1","author":"Vicente","year":"2021","journal-title":"Emerg. Trends Drugs Addict. Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"109244","DOI":"10.1016\/j.drugalcdep.2021.109244","article-title":"Significant toxicity following an increase in poisonings with designer benzodiazepines in the Netherlands between 2010 and 2020","volume":"231","author":"Essink","year":"2022","journal-title":"Drug Alcohol Depend."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1177\/0960327118788146","article-title":"Anion gap and base deficit are predictors of mortality in acute pesticide poisoning","volume":"38","author":"Lee","year":"2019","journal-title":"Hum. Exp. Toxicol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1038\/nrneph.2010.33","article-title":"Metabolic acidosis: Pathophysiology, diagnosis and management","volume":"6","author":"Kraut","year":"2010","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e93","DOI":"10.1097\/CCM.0b013e318283d124","article-title":"Stress hyperglycemia: An essential survival response!","volume":"41","author":"Marik","year":"2013","journal-title":"Crit. Care Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e14713","DOI":"10.14814\/phy2.14713","article-title":"Stress hyperglycemia, cardiac glucotoxicity, and critically ill patient outcomes current clinical and pathophysiological evidence","volume":"9","author":"Scheen","year":"2021","journal-title":"Physiol. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"634","DOI":"10.12968\/hmed.2018.79.11.634","article-title":"Stress-induced hyperglycaemia","volume":"79","author":"Mifsud","year":"2018","journal-title":"Br. J. Hosp. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/S1726-4901(10)70006-X","article-title":"Features and prognostic factors for elderly with acute poisoning in the emergency department","volume":"73","author":"Hu","year":"2010","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1093\/tropej\/fmq099","article-title":"Changing trends and predictors of outcome in patients with acute poisoning admitted to the intensive care","volume":"57","author":"Jayashree","year":"2011","journal-title":"J. Trop. 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