Key result
Clinical digoxin toxicity affects ~30% of ED patients with elevated levels and links to higher hospitalization.
Cross-Sectional (n=137)
No
In patients presenting to the ED with elevated digoxin levels, older age is significantly associated with clinical intoxication, which correlates with higher hospitalization and mortality rates.
Answers are grounded in this paper and cite their sources.
May support closer monitoring of older ED patients with elevated digoxin; leaves open prospective validation of toxicity thresholds.
OBJECTIVES: We investigated the demographic characteristics, clinical and laboratory findings, treatment strategies and clinical outcomes of patients presenting at emergency department (ED) with digoxin levels at or above 1.2 ng/ml. MATERIALS AND METHODS: The demographic and clinical characteristics of patients with serum digoxin levels at or above 1.2 ng/ml admitted to an ED between January 2010 and July 2011 were investigated in this cross-sectional descriptive study. Patients with ECG and clinical findings consistent with digoxin toxicity and no additional explanation of their symptoms were evaluated for digoxin toxicity. RESULTS: In this study 137 patients were included, and 68.6% of patients were women with mean age 76.1 ± 12.2. There was no significant difference between gender and digoxin intoxication. The mean age of intoxicated group was significantly higher than the non-intoxicated group (P = 0.03). The most common comorbidities were congestive heart failure (n = 91) and atrial fibrillation (n = 74). The most common symptoms were nausea, vomiting and abdominal pain. The levels of hospitalization and mortality in this group were significantly higher. CONCLUSION: Digoxin intoxication must be suspected in patients present in the ED, particularly those with complaints that include nausea and vomiting, as well as new ECG changes; serum digoxin levels must be determined.
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Limon et al. (2016) conducted a cross-sectional in Elevated serum digoxin levels (≥1.2 ng/ml) (n=137). Digoxin toxicity (clinical and ECG findings consistent with toxicity) vs. Elevated digoxin levels without clinical toxicity was evaluated on Prevalence of clinical digoxin toxicity among patients with serum digoxin ≥1.2 ng/ml. Digoxin toxicity occurred in 29.9% of ED patients with digoxin levels ≥1.2 ng/ml, associating with older age and higher hospitalization rates.
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