Medical Journal of the Islamic Republic Of Iran

en Predictive Factors of Abnormal Brain CT Scan in Patients with Opioid Poisoning: A Single-Center Study Emergency Medicine Emergency Medicine Original Research Original Research Background: Opioid poisoning is a major cause of morbidity and mortality, particularly in Iran; however, no clear guidelines exist regarding the appropriate timing for non-contrast BCTS in these patients. This study aims to identify clinical and laboratory factors that predict abnormal BCTS findings in individuals with opioid poisoning. We conducted the study among patients presenting to the emergency department of Shiraz Namazi Hospital with opioid poisoning.    Methods: This retrospective cross-sectional study was performed on 208 patients with opioid poisoning who were referred to the emergency department of Namazi Hospital between March 2019 and March 2021. Data collection involved accessing the archives of Namazi Hospital to gather the necessary information for this study.    Results: Among 208 patients with opioid poisoning who underwent brain CT, 57 (27.4%) exhibited abnormal BCTS findings within this selected subgroup. Multivariable logistic regression identified two independent predictive factors for abnormal BCTS: advanced age (OR 1.041 per year; 95% CI 1.01–1.07; P=0.008) and lower serum bicarbonate (OR 0.908 per mEq/L; 95% CI 0.83–0.99; P=0.025). The most prevalent abnormal findings included microvascular ischemic damage, followed by ischemic infarctions.    Conclusion: Advanced age and lower serum bicarbonate levels are independent predictors of abnormal BCTS findings in patients with acute opioid poisoning. Clinicians should consider urgent BCTS in older patients or those with metabolic acidosis, as these groups are at higher risk and may derive the greatest benefit from emergent neuroimaging.     Poisoning, Opioid, Brain CT scan, Opium, methadone, heroin, Pethidine, Tramadol, ischemia, infarction 758 764 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-10149-1&slc_lang=en&sid=1 Alireza Abbasi alireza12abbasi@gmail.com 200319475328460099418 200319475328460099418 No Artificial Intelligence Clinical Laboratory and Biological Data Bank‎, Shiraz University of Medical Sciences, Shiraz, Iran Mohammad Farhadi fsunroo@gmail.com 200319475328460099419 0009-0009-6713-0954 No Clinical Research Development Center, Amir Oncology Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Robab Sadegh dr.sadegh.robab@gmail.com 200319475328460099420 200319475328460099420 Yes Emergency Medicine Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Kiarash Kavari Kiarashkavari98@gmail.com 200319475328460099421 200319475328460099421 No School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Faezeh Rastaghi Rastaghii.f@gmail.com 200319475328460099422 0009-0008-6511-6633 No Clinical Research Development Center, Amir Oncology Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Fatemeh Parvizi Parvizi.fatemeh@yahoo.com 200319475328460099423 0009-0000-9826-2049 No School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Zeinab Azadian zeinabazdd@gmail.com 200319475328460099424 0009-0005-6627-5511 No Clinical Research Development Center, Amir Oncology Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Amir Hossein Rajabi ahrajabi@sums.ac.ir 200319475328460099425 0009-0004-1321-4187 No School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Amin Nasr پ aminnasr427@gmail.com 200319475328460099426 0009-0008-5951-1127 No School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran