Abstract / Summary
Abstract Background: Gastric lavage remains in use for psychotropic drug poisoning, but whether factors associated with its selection identify patients who develop clinically important toxicity is uncertain. We compared factors associated with lavage selection with factors associated with clinically actionable toxicologic events (CATEs). Methods: We conducted a single-center retrospective cohort study of 182 patients hospitalized from 2016 to 2025. Initial high clinical risk was defined by abnormal consciousness, respiratory rate, systolic blood pressure, heart rate, oxygen saturation, or electrocardiography. Multivariable logistic regression examined factors associated with lavage and CATEs. Results: Lavage was performed in 81 patients (44.5%), and 40 (22.0%) experienced a CATE. Arrival within 6 h was associated with lavage selection (adjusted odds ratio [aOR], 2.83; 95% confidence interval [CI], 1.50–5.33), whereas initial high risk was not (aOR, 1.41; 95% CI, 0.74–2.69). Conversely, initial high risk was associated with CATEs (aOR, 5.85; 95% CI, 2.62–13.08), whereas arrival within 6 h (aOR, 0.91; 95% CI, 0.41–2.03) and lavage (aOR, 1.46; 95% CI, 0.65–3.25) were not. Conclusions: Lavage selection and clinically important toxicity were associated with different factors. A conventional time window should not be used as a stand-alone trigger for lavage; bedside physiology may be more informative for monitoring and escalation decisions.