Table 2 Characteristics of the studies included in the systematic review and meta-analysis.
ID | Author/reference | Year | Country continent | Design | Age* | Sex | Sample size | Poisoning drug | Participants | Multi-intoxication | Dose | Route of administration | PMH | Risk of bias |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Aghabiklooei15 | 2014 | Iran/EM | Cross-sectional | 36.0 ± 15.8 | (74.8%)M/(25.2%)F | 322 | Methadone | 2007–2012/total hospitalized | No | 85.91 ± 82.61 (mg) | Oral | No | ******* |
2 | Arefi16 | 2014 | Iran/EM | Cross-sectional | 30.55 ± 15.8 | (52%)M/(48%)F | 1500 | Multiple drugs/opium/alcohol/sedative | During year 2010/total hospitalized | NA | NA | Oral/IV/inhalation | No | ******** |
3 | Armenian17 | 2012 | USA/America | Case series | 22.42 mean (19–35) | (58.3%)M/(41.7%)F | 12 | AMPH/MDMA | May 30, 2010/ICU hospitalized | No | 0.75 ± 0.48 (mg/l) | Oral | No | ***** |
4 | Azarakhshi18 | 2021 | Iran/EM | Retrospective | 38.26 ± 25.91 | (75.8%)M/(24.2%)F | 227 | Opium | Mar 2006–Mar 2016/total hospitalized | No | 4456 ± 10,317 (mg) | Oral | NA | ****** |
5 | Brahmi19 | 2007 | Tunisia/WP | Case series | 21.5 mean (16–53) | (93.75%)M/(6.25%)F | 16 | Methanol | Dec 2003–Apr 2004/ICU hospitalized | No | 250 ml (range 30–1000) | Oral | NA | ****** |
6 | Bruggisser20 | 2009 | Switzerland/Europe | Retrospective | 29.21 ± 12.54 | (61.3%)M/(38.7%)F | 220 | MDMA/cocaine/AMPH | 1997 and 2009/total hospitalized | No | NA | Oral/nasal/IV/inhalation | NA | ******* |
7 | 2019 | USA/America | Cross-sectional | 50 median (34–60) | (47.2%)M/(52.8%)F | 570,987 | Opium/methadone/heroin/other opiates/narcotic | In 2010–2014/total hospitalized | Cocaine/AMPH/BDZ/aromatic analgesic | NA | NA | HTN/MDD/Psychiatric/AKI | ******** | |
8 | 2003 | Australia/WP | Case series | 25 mean | (57.9%)M/(42.1%)F | 19 | MDMA/PMA | Jan 1999–Dec 2001/total hospitalized | BARB/THC/BDZ | NA | Oral | NA | ***** | |
9 | Chhabra23 | 2017 | USA/America | Retrospective | 21 median (19.5–24) | (53.6%)M/(46.4%)F | 28 | Ethanol/ecstasy/marijuana/LSD/cocaine | The 3-day/total hospitalized | No | NA | Oral | NA | ***** |
10 | Dabby24 | 2006 | Israel/Europe | Research report | 29.5 mean (22–42) | (100%)M | 6 | Heroin | In 2001 and 2005/total hospitalized | No | NA | Sniffing/IV | Hepatitis C | ***** |
11 | Forrester25 | 2021 | USA/America | Retrospective | 23 mean (12–67) | (74.2%)M/(25.8%)F | 454 | Synthetic cannabinoids | During 2010/total hospitalized | Alcohol/alprazolam/cocaine/acetaminophen | NA | Inhalation/oral | NA | ****** |
12 | Gilley26 | 2021 | USA/America | Prospectively | 16 to 19 | (91%)M/(9%)F | 75 | Synthetic cannabinoids | Sep 2008–Feb 2011/total hospitalized | NA | NA | NA | NA | ****** |
13 | Greene27 | 2003 | England/Europe | Case series | 19.4 mean (17–23) | (85.7%)M/(14.3%)F | 7 | Ecstasy/MDMA | One day between the hours of 6 and 8 AM/total hospitalized | No | 0.63 ± 0.83 (mg/l) | Oral | NA | ***** |
14 | Halpern28 | 2010 | Israel/Europe | Prospective | 24.2 ± 6.3 | (63%)M/(37%)F | 52 | Ecstasy/MDMA | Aug 2002–Feb 2003/total hospitalized | Alcohol/opiates/cocaine/cannabis/BDZ/LSD | NA | Oral | NA | ****** |
15 | Hermanns-Clausen29 | 2012 | Germany/Europe | Retrospective | 19 median (14–30) | (86.2%)M/(13.8%)F | 29 | Synthetic cannabinoids | Sep 2008–Feb 2011/total hospitalized | AMPH/BDZ/lorazepam/MAMP | 10.99 ± 13.91 (ng/ml) | NA | NA | ****** |
16 | 2008 | Norway/Europe | Prospective cross-sectional | ≥ 16 years | – | 947 | Methanol/AMPH/opioids/ethanol/cocaine | Apr 2003–Mar 2004/total hospitalized | Codeine/paracetamol/BDZ/opioid | NA | Oral | NA | ******* | |
17 | 2013 | USA/America | Case series | 35.4 mean (28–42) | (100%)M | 5 | AMPH | May–December 2011/ICU hospitalized | Cannabinoids/cocaine | NA | Ingestion/smoke | Bipolar/ADHD/MDD/anxiety | ***** | |
18 | Isoardi32 | 2019 | Australia/WP | Retrospective/observational | 31 median (16–68) | (71%)M/(29%)F | 329 | MAMP | During 2016/total hospitalized | Alcohol/cannabis/BDZ/heroin/MDMA | NA | IV/inhalation/oral | NA | ****** |
19 | Isoardi33 | 2020 | Australia/WP | Prospective/observational | 32 median (28–31) | (85.4%)M/(14.6%)F | 48 | MAMP | Dec 2017–Sep 2018/total hospitalized | Opioid/aspirin/ethanol/LSD/GHB/marijuana | NA | IV/inhalation/oral | NA | ******* |
20 | Kaewput34 | 2020 | USA/America | Retrospective cohort | 37.9 ± 18.3 | (69.5%)M/(30.5%)F | 603 | Methanol | From 1993–2014/total hospitalized | No | NA | oral | ObesityHTN/CKD/DM | ****** |
21 | Kamijo35 | 2014 | Japan/WP | Retrospective | 28.4 ± 8.4 | (82%)M/(18%)F | 518 | Synthetic cannabinoid | Jan 2006–Dec 2012/total hospitalized | Alcohol/BDZ psychotropic drug | NA | Inhalation/ingestion/sniffing/anal | NA | ****** |
22 | Kasper36 | 2018 | USA/America | Case Reports | 29 median (23.5–36.5) | (80%)M/(20%)F | 56 | Synthetic cannabinoids | Apr–May 2015/total hospitalized | Cannabinoids/BDZ cocaine/AMPH | NA | NA | HTN/seizure/mental illness | ****** |
23 | Katz37 | 2016 | USA/America | Case series | 22.36 mean (13–50) | (63.6%)M/(36.4%)F | 11 | Synthetic cannabinoids | Apr 2015/ICU hospitalized | Caffeine/morphine/midazolam/ethanol/AMPH/lorazepam | NA | NA | Hepatitis/bipolar/epilepsy | ***** |
24 | 2017 | Iran/EM | Cross-sectional | 37.69 ± 5.87 | (82.2%)M/(17.8%)F | 354 | Methadone/tramadol/opium/cocaine/heroin | 2014/ICU hospitalized | No | NA | NA | NA | ****** | |
25 | 2021 | Canada/America | Cross-sectional | 44.7 mean (31–54) | (57.3%)M/(42.7%)F | 3552 | Opium/heroin/methadone/synthetic/semisynthetic | Jan 2010–Dec 2019/total hospitalized | No | NA | Oral/inhalation/IV | NA | ****** | |
26 | 2020 | USA/America | Case series | 41 (25–59) | (80%)M/(20%)F | 30 | Synthetic cannabinoid | 2014–2016/ICU hospitalized | Cannabinoids/BDZ cocaine/opioid//methadone | NA | Ingestion | Psychiatric illness/personality disorder | ***** | |
27 | 2010 | China/WP | Cross sectional | 38 (30–49) | (45.7%)M/(54.3%)F | 265 | Alcohol BDZ/TCA | Jan 2000–May 2008/ICU hospitalized | No | NA | NA | Psychiatric disease/MDD | ****** | |
28 | Lavergne12 | 2016 | USA/America | Retrospective | 43.7 mean (43.7–44.9) | – | 1745 | Ethanol/methanol/cocaine/methadone | 1993–2014/total hospitalized | No | NA | NA | NA | ****** |
29 | Lund42 | 2012 | Norway/Europe | Cross sectional | 36 (16–93) | (55.5%)M/(44.5%)F | 1065 | Ethanol/opioids/cocaine/AMPH/BDZ | Apr 2008–Apr 14, 2009/total hospitalized | BDZ/paracetamol/ethanol/anabolic steroids | NA | NA | NA | ****** |
30 | 2020 | USA/America | Retrospective toxic registry | 41.9 ± 16.6 | (60.2%)M/(39.8%)F | 973 | Methadone | Jan 2010–Dec 2017/total hospitalized | NA | 111.34 ± 121.78 (mg) | Oral/parenteral | NA | ******* | |
31 | Melli44 | 2005 | USA/America | Prospective | 47 median (4–95) | (68.2%)M/(31.8%)F | 475 | Illicit drugs/alcohol | Jan 1993–Dec 2001/total hospitalized | No | NA | NA | No | ****** |
32 | Monte45 | 2017 | USA/America | Prospective | 25 median (18–36) | (84.1%)M/(15.9%)F | 353 | Synthetic cannabinoids | Jan 2010–Jul 2015/total hospitalized | Marijuana/sympathomimetic | NA | Inhalation | NA | ****** |
33 | Mozafari46 | 2016 | Iran/EM | Cross sectional | 32.65 ± 14.4 | (59%)M/(41%)F | 310 | AMPH/opium/methanol/tramadol/methadone | Feb 2014–Feb 2015/ICU hospitalized | No | NA | NA | No | ******* |
34 | Morrow47 | 2019 | Canada/America | Retrospective cohort | 48 median (32–61) | (53.5%)M/(46.5%)F | 2554 | Opium/heroin/methadone/other opioids | 2006 to 2015/total hospitalized | No | NA | NA | Psychiatric /Pneumonia/HIV/cancer | ******* |
35 | Ng48 | 2019 | Hong Kong/WP | Retrospective | 36.5 median (27.5–53.2) | (56.3%)M/(43.7%)F | 270 | Ethanol/heroin/cocaine/AMPH/cannabis/tramadol | Jan 2007–Dec 2016/ICU hospitalized | NA | NA | Oral/inhalation/parenteral/insufflation | Psychiatric/schizophrenia, | ***** |
36 | 2015 | Canada/America | Retrospective case series | 24 median (14–52) | (81.5%)M/(18.5%)F | 27 | PMA/MDMA | Jun 2011–Apr 2012/total hospitalized | AMPH/cocaine/MAMP | 2.70 ± 1.72 (mg/l) | Oral | NA | **** | |
37 | 2015 | USA/America | Retrospective chart review | 32 median (25–42) | (74%)M/(26%)F | 89 | Synthetic cathinone’s/MAMP/cocaine | Jan 2010–Jan 2013/total hospitalized | No | NA | Ingestion | NA | ******** | |
38 | 2020 | USA/America | Cross sectional | 44.6 ± 0.1 | (55%)M/(45%)F | 2,528,751 | Opium/heroin/methadone | Jan 2010–Dec 2014/total hospitalized | No | NA | NA | Hepatitis C | ******* | |
39 | 2018 | Iran/EM | Retrospective cross-sectional | 34.9 ± 14.5 | (77%)M/(23%)F | 315 | Alcohol/opium | Jul 2011 and Jul 2017/total hospitalized | No | NA | NA | No | ****** | |
40 | Rahimi53 | 2018 | Iran/EM | Retrospective cross-sectional | 32.9 ± 10.9 | (77%)M/(23%)F | 226 | AMPH | Apr 2011–Mar 2014/total hospitalized | No | 1.64 ± 1.59(gram) | Oral/inhalation/ injection | NA | ******* |
41 | 2022 | Iran/EM | Prospective | 33 median (25, 49) | (92.7%)M/(7.3%)F | 165 | Opium/heroin/methadone/tramadol | Sep 2019–Mar 2020/ICU hospitalized | NA | NA | Oral/inhalation | DM/COPD/CHF/CVD/seizure | ****** | |
42 | Richards9 | 2020 | USA/America | Retrospective review | 46 ± 15 | (69%)M/(31%)F | 215 | Cocaine | Jul 2012–Jul 2017/total hospitalized | AMPH ethanol | NA | NA | CVD/psychiatric/neurological/GI/GU | ******** |
43 | Richards55 | 2020 | USA/America | Retrospective review | Median 43 ± 13 | (71%)M/(29%)F | 957 | MAMP AMPH | Jul 2012–Jul 2017/total hospitalized | Cocaine ethanol | NA | NA | Psychiatric/endocrine/GI/GU/ neurological | ******** |
44 | Riederer56 | 2017 | USA/America | Case reports | 70.6 (19–65) 27.4 (13–18) | (83.1%)M/(16.9%)F | 456 | Synthetic cannabinoids | Jan 2010–Nov 2015/total hospitalized | No | NA | NA | NA | ******* |
45 | Ridpath57 | 2014 | USA/America | Case report | 21 median (16–29) | (41%)M/(59%)F | 22 | Alcohol/cocaine/ MDMA | Sep 2013 over the 3-day/total hospitalized | Synthetic club drug/marijuana/other drugs | NA | NA | NA | ***** |
46 | Sheibani11 | 2021 | Iran/EM | Observational | 33 (24–46) 63 (38–71) | (75.9%)M/(24.1%)F | 245 | Methadone | Jun 2018–Feb 2019/ICU hospitalized | No | NA | Oral | No | ****** |
47 | 2001 | USA/America | Retrospective chart review | 34 | (85.2%)M/(14.8%)F | 27 | Heroin | Aug 1994–Dec 1998/total hospitalized | No | NA | NA | NA | ***** | |
48 | Taheri59 | 2013 | Iran/EM | Cross-sectional | 36.2 ± 14.50 | (91.5%)M/(8.5%)F | 82 | Alcohol/narcotic/psychotropic | During a 6-month period in 2012/total hospitalized | No | NA | NA | NA | ****** |
49 | Talaie8 | 2007 | Iran/EM | Cross sectional | 32.43 ± 14.31 | (64.6%)M/(35.4%)F | 181 | Opium/alcohol/heroin | Sep 2004–Sep 2005/ICU hospitalized | BZD/TCA/carbamazepine/phenobarbital | NA | NA | No | ****** |
50 | 2019 | Iran/EM | Cross-sectional | – | (71.8%)M/(28.2%)F | 170 | Opioid/methadone/stimulants | Jun 2015–Mar 2017/ICU hospitalized | Opioid/stimulants/TCA/CO | NA | NA | No | ****** | |
51 | 2020 | Iran/EM | Prospective/observational/cohort | 39.43 ± 16.27 | (67.4%)M/(32.6%)F | 184 | Methadone/tramadol/AMPH/opiate | Oct 2019–Aug 2020/ICU hospitalized | NA | NA | NA | Neurological/CVA/psychiatric | ******* | |
52 | 2019 | USA/America | Retrospective case series | 47 median (32–54) | (83%)M/(17%)F | 23 | Synthetic cannabinoids | Jan–Dec 2015/ICU hospitalized | Alcohol/BDZ/opioid/AMPH/cocaine/phencyclidine | NA | NA | NA | ***** | |
53 | Thongprayoon4 | 2021 | USA/America | Retrospective cohort | 37.9 ± 18.3 | (69.8%)M/(30.2%)F | 603 | Methanol | 2003–2014/total hospitalized | NA | NA | oral | DM/HTN /anemia/CVA/CKD | ******* |
54 | Waldman10 | 2021 | 10 countries/Europe | Retrospective | 30 median (12–88) | (76.3%)M/(23.7%)F | 1015 | Cocaine/cannabis/AMPH/ heroin | Oct 2013–Sep 2014/total hospitalized | No | NA | NA | NA | ******* |
55 | Weng63 | 2022 | Taiwan/WP | Retrospective | 37 median (30–43.7) | (78.4%)M/(21.6%)F | 379 | MAMP | May 2017–Apr 2021/total hospitalized | No | NA | NA | Psychiatric/DM/HTN/cancer | ****** |
56 | West64 | 2010 | USA/America | Observational case series | 27 median (16–57) | (80%)M/(20%)F | 55 | MAMP | Jan 2001–Jul 2007/total hospitalized | Cannabinoids/BDZ/opiate/cocaine/BARB | Median 3.5 g | Oral/ingestion | NA | ***** |
57 | Yalçın65 | 2019 | Turkey/Europe | Retrospective | 26.8 ± 7.5 | (92.6%)M/(7.4%)F | 340 | Synthetic cannabinoids | Feb–May 2016/total hospitalized | Cannabis/alcohol | NA | NA | Psychiatric illness | ******* |
