Scholarlink

Background <p>Immunochromatography-based urine drug screening (UDS) can have false-positive or false-negative results; thus, interpretation of results requires careful evaluation. A UDS-negative result simply indicates that target drugs were not detected in urine and does not rule out acute poisoning. This study aimed to determine the presence of drugs in the blood and blood drug concentrations in suspected cases of acute poisoning with UDS-negative results.</p> Methods <p>In this single-center, retrospective, observational study, we included 501 patients who attended Tokai University Hospital Advanced Emergency Medical Center, Japan, between January 1, 2014 and December 31, 2023 and were diagnosed with acute poisoning with negative UDS results. The primary outcome included the detection rate of UDS items and non-UDS items in blood samples. The secondary outcome included the classification of blood drug concentrations (below therapeutic range, within therapeutic range, above therapeutic range). Blood drug concentrations were measured using a gas chromatography–mass spectrometer and liquid chromatography–tandem mass spectrometer.</p> Results <p>Blood drug concentrations were detected in 498 (99.4%) of the 501 participants. Despite negative UDS results in urine, UDS items were detected in blood samples of 239 patients (58.8%). Non-UDS items were detected in 430 participants (86.3%). Benzodiazepines were the most commonly detected UDS items, with many cases exhibiting blood drug concentrations above the therapeutic range. In non-UDS items, non-benzodiazepine hypnotics, antipsychotics, and over-the-counter (OTC) medications were often detected.</p> Conclusion <p>This study demonstrates that negative UDS results do not rule out the presence of drugs in acute poisoning cases. Moreover, a comprehensive evaluation, including physical and laboratory findings, is essential for accurate diagnosis and treatment.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Evaluation of immunochromatography-based urine drug screening and blood drug concentrations in suspected acute poisoning: insights into negative urine drug screening results

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月12日

查看全文
  • Rie Yamamoto,
  • Yukari Maki,
  • Yuri Iketani,
  • Tomoatsu Tsuji,
  • Takeshi Saito,
  • Seiji Morita

摘要

Background

Immunochromatography-based urine drug screening (UDS) can have false-positive or false-negative results; thus, interpretation of results requires careful evaluation. A UDS-negative result simply indicates that target drugs were not detected in urine and does not rule out acute poisoning. This study aimed to determine the presence of drugs in the blood and blood drug concentrations in suspected cases of acute poisoning with UDS-negative results.

Methods

In this single-center, retrospective, observational study, we included 501 patients who attended Tokai University Hospital Advanced Emergency Medical Center, Japan, between January 1, 2014 and December 31, 2023 and were diagnosed with acute poisoning with negative UDS results. The primary outcome included the detection rate of UDS items and non-UDS items in blood samples. The secondary outcome included the classification of blood drug concentrations (below therapeutic range, within therapeutic range, above therapeutic range). Blood drug concentrations were measured using a gas chromatography–mass spectrometer and liquid chromatography–tandem mass spectrometer.

Results

Blood drug concentrations were detected in 498 (99.4%) of the 501 participants. Despite negative UDS results in urine, UDS items were detected in blood samples of 239 patients (58.8%). Non-UDS items were detected in 430 participants (86.3%). Benzodiazepines were the most commonly detected UDS items, with many cases exhibiting blood drug concentrations above the therapeutic range. In non-UDS items, non-benzodiazepine hypnotics, antipsychotics, and over-the-counter (OTC) medications were often detected.

Conclusion

This study demonstrates that negative UDS results do not rule out the presence of drugs in acute poisoning cases. Moreover, a comprehensive evaluation, including physical and laboratory findings, is essential for accurate diagnosis and treatment.