Strox: A 3-year study of intoxicated cases admitted to Poison Control Center Ain Shams University Hospitals

Introduction: Synthetic cannabinoids abuse is a global concern, creating new challenges for treatment services. Strox is a version of synthetic cannabinoids that emerged and became increasingly popular in Egypt. Aim: To study socio-demographic and clinical characteristics in addition to causes of deaths in patients with acute Strox toxicity who presented to Poison Control Center Ain Shams University Hospitals (PCCA). Methods: a cross-sectional hospital-based observational study was carried out on 92 patients with Strox toxicity during a 3 year period from 2018 to 2020. Recorded data included: age, gender, route, mode of exposure and vital data. Investigation including arterial blood gases (ABG), liver function tests (LFT) and renal function tests (RFT) and ECG were done. Outcome data including duration of hospital stay, intensive care unit (ICU) admission and mortality rate were recorded. Results: Cases were mainly in the age group between 13-40 years (82.6%), males (93.5%) and due to addiction (90.2 %). Coma and agitation were the main recorded presentations (63% and 34% respectively). Shock and respiratory failure were recorded in 12% and 22% respectively, while liver and renal impairment were recorded in 5% and 3% respectively. Sever intoxication was diagnosed in 78.3% with mortality rate 11%. Deaths were due to cardiac insults in 50% of the patients. Conclusion: The incidence of strox toxicity has recently increased in Egypt with high mortality rate. Cardiac and respiratory complication are the most common causes of death. Until now little is known about the pattern of acute poisoning by strox poisoning, so early recognition of sever cases and close observation in ICU with early resuscitation could help in lowering the mortality rate.