Investigation The Cause and Prevalence of Digoxin Poisoning in Cardiac Patients hospitalized in Firoozgar Hospital in Tehran Between 2011 and 2015

Due to prescribing high doses of digoxin for cardiac patients and the importance of its poisoning, this study aimed to survey the correlation between prevalence of digoxin serum level with poisoning symptoms, determining the role of interventional factors such as underlying diseases, electrolyte and metabolic disorders in association with the occurrence of poisoning, determination of the prevalence of cardiac and non-chronic signs of chronic poisoning with digoxin in cardiac patients who receive digoxin.
This was a cross sectional study which was conducted on 531 hospitalized patients using. Patient information including cardiac and non-cardiac symptoms, and laboratory findings, especially digoxin serum levels, were extracted from clinical records and analyzed statistically.
Findings: Poisoning prevalence with Digoxin in patients were 10% and 97.9% out of 52 patients with Digoxin poisoning, related to Chronic poisoning in patients treated with digoxin and only 2 cases were acute poisoning due to attempted suicide. 60% of patients were females and the mean age of patients was 78±11.3. The mean level of digoxin serum in male and female groups were 2.81±0.13 ng/ml and 2.94±0.07 ng/ml, respectively. There was a significant difference in the mean serum level of patients over 65 and under 65 years old (3.28 ± 0.14 ng/mL and 2.66 ± 0.09 ng/mL respectively). In 62% of patients, renal function enzymes were increased. Subacute renal disease or acute renal failure was the most important cause of digoxin poisoning.
The high age and subacute renal disease or acute renal failure are the most important factors in prediction of the occurrence probability of Digoxin poisoning in patients treated with this drug. Age over 65 years-old increases the risk of poisoning up to 2 or 3 times.