2014 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 32nd Annual Report

Mowry, James B.; Spyker, Daniel A.; Brooks, Daniel E.; McMillan, Naya; Schauben, Jay L.

doi:10.3109/15563650.2015.1102927

Cited by 455 publications

(317 citation statements)

References 4 publications

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“…Sedative hypnotics and muscle relaxants were the second most commonly reported agent class, and the sedative hypnotic toxidrome was the most common toxidrome. This is consistent with NPDS data which found the sedative/hypnotics/antipsychotics agent class to have the greatest increase in serious exposures in 2014 [16]. Clonazepam and alprazolam were the top reported sedative hypnotic drugs in the ToxIC Registry in 2015.…”

Section: Discussionsupporting

confidence: 87%

The Toxicology Investigators Consortium Case Registry—the 2015 Experience

Rhyee¹,

Campleman²,

Ruha³

et al. 2016

J. Med. Toxicol.

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The American College of Medical Toxicology established the Toxicology Investigators Consortium (ToxIC) Case Registry in 2010. The Registry contains all medical toxicology consultations performed at participating sites. The Registry has continued to grow since its inception, and as of December 31, 2015, contains 43,099 cases. This is the sixth annual report of the ToxIC Registry, summarizing the additional 8115 cases entered in 2015. Cases were identified by a query of the Registry for all cases entered between January 1 and December 31, 2015. Specific data reviewed for analysis included demographics (age, race, gender), source of consultation, reason for consultation, agents and agent classes involved in exposures, signs, symptoms, clinical findings, fatalities, and treatment. By the end of 2015, there were 50 active sites, consisting of 101 separate health-care facilities; 51.2 % of cases involved females. Adults between the ages of 19 and 65 made up the majority (64.2 %) of Registry cases. Caucasian race was the most commonly reported (55.6 %); 9.6 % of cases were identified as Hispanic ethnicity. Inpatient and emergency department referrals were by far the most common referral sources (92.9 %). Intentional pharmaceutical exposures remained the most frequent reason for consultation, making up 52.3 % of cases. Of these intentional pharmaceutical exposures, 69 % represented an attempt at self-harm, and 85.6 % of these were a suicide attempt. Nonopioid analgesics, sedative-hypnotics, and antidepressant agents were the most commonly reported agent classes in 2015. Almost one-third of Registry cases involved a diagnosed toxidrome (32.8 %), with a sedative-hypnotic toxidrome being the most frequently described. Significant vital sign abnormalities were recorded in 25.3 % of cases. There were 98 fatalities reported in the Registry (1.2 %). Adverse drug reactions were reported in 4.3 % of cases. Toxicological treatment was given in 65.3 % of cases, with 33.0 % receiving specific antidotal therapy. Exposure characteristics and trends overall were similar to prior years. While treatment interventions were required in the majority of cases, fatalities were rare.

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Section: Discussionsupporting

confidence: 87%

The Toxicology Investigators Consortium Case Registry—the 2015 Experience

Rhyee¹,

Campleman²,

Ruha³

et al. 2016

J. Med. Toxicol.

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“…This finding agrees with previous research indicating that this is the only age group in which intentional poisonings are more common than unintentional ones. 22 Also consistent with previous research, boys accounted for a larger proportion of intentional opioid exposures than girls. 41 The majority of teenage fatalities resulting from intentional opioid exposures were among boys, but girls comprised a greater proportion of suspected suicide exposures.…”

Section: Exposures Among Teenagerssupporting

confidence: 79%

“…PCC specialists receive telephone calls reporting poison exposures, provide medical advice on exposure management, and record details about each exposure. 22 …”

Section: Data Sources and Study Designmentioning

confidence: 99%

Prescription Opioid Exposures Among Children and Adolescents in the United States: 2000–2015

et al. 2017

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OBJECTIVES: This study analyzes and compares exposures to prescription opioids among children and adolescents younger than 20 years old in the United States. METHODS:Data from the National Poison Data System for 2000 through 2015 were analyzed. RESULTS:Poison control centers received reports of 188 468 prescription opioid exposures among children aged <20 years old from 2000 through 2015. The annual number and rate of exposures increased early in the study period, but declined after 2009, except for buprenorphine exposures, which increased during the last 3 study years. Hydrocodone accounted for the largest proportion of exposures (28.7%), and 47.1% of children exposed to buprenorphine were admitted to a health care facility (HCF). The odds of being admitted to an HCF were higher for teenagers than for children aged 0 to 5 years (odds ratio [OR]: 2.86; 95% confidence interval [CI]: 2.78-2.94) or children aged 6 to 12 years (OR: 6.62; 95% CI: 6.06-7.02). Teenagers also had greater odds of serious medical outcomes than did children aged 0 to 5 years (OR: 3.03; 95% CI: 2.92-3.15) or children aged 6 to 12 years (OR: 4.59; 95% CI: 4.21-5.00). The rate of prescription opioid-related suspected suicides among teenagers increased by 52.7% during the study period.CONCLUSIONS: Prescription opioid-related HCF admissions and serious medical outcomes were higher among teenagers. Contrary to trends for other prescription opioids, exposures to buprenorphine have increased in recent years; children aged 0 to 5 years accounted for almost 90% of buprenorphine exposures. These findings indicate that additional prevention efforts are needed.

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“…Although the vast majority of patients with poisoning exposures are managed at home or on site, those who require a higher level of care are often initially treated in emergency departments (EDs) [4]. An increase in the number of poisoning-related visits and an increase in the intensity of care associated with such visits could have important implications for ED operations and patient care [5].…”

Section: Introductionmentioning

confidence: 99%

Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011

et al. 2016

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In recent years, there has been an increase in poisoning-related emergency department (ED) visits. This study examines trends in ED resource utilization for poisoning-related visits over time. A retrospective review of data from the National Hospital Ambulatory Medical Care Survey, 2003-2011, was conducted. All ED visits with a reason for visit or ICD-9 code related to poisoning were included. We examined the number of ED visits and resources used including diagnostic studies and procedures performed, medications provided, admission rates, and length of stay. The proportion of visits involving resource use was tabulated and trends analyzed using survey-weighted logistic regression, grouping into 2-year periods to ensure adequate sample size. Of an estimated 843 million ED visits between 2003 and 2011, 8 million (0.9 %) were related to poisoning. Visits increased from 1.8 million (0.8 %) visits in [2003][2004] to 2.9 million (1.1 %) visits in 2010-2011, p = 0.001. Use of laboratory studies, EKGs, plain radiographs, and procedures remained stable across the study period. CT use was more than doubled, increasing from 5.2 to 13.7 % of visits, p = 0.001. ED length of stay increased by 35.5 % from 254 to 344 min, p = 0.001. Admission rates increased by 45.3 %, from 15.0 to 21.8 %, p = 0.046. Over the entire study period, 52.0 % of poisoned patients arrived via ambulance, and 3.0 % of patients had been discharged from the hospital within the previous 7 days. Poisoning-related ED visits increased over the 8-year study period; poisonings are resource-intensive visits and require increasingly longer lengths of ED stay or hospital admission.

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2014 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 32nd Annual Report

Cited by 455 publications

References 4 publications

The Toxicology Investigators Consortium Case Registry—the 2015 Experience

The Toxicology Investigators Consortium Case Registry—the 2015 Experience

Prescription Opioid Exposures Among Children and Adolescents in the United States: 2000–2015

Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011

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