A one-year observational study of all hospitalized and fatal acute poisonings in Oslo: Epidemiology, intention and follow-up

Abstract

BackgroundUp to date information on poisoning trends is important. This study reports the epidemiology of all hospitalized acute poisonings in Oslo, including mortality, follow-up referrals, and whether the introduction of over-the-counter sales of paracetamol outside pharmacies had an impact on the frequency of poisonings.MethodsAll acute poisonings of adults (≥16 years) treated at the five hospitals in Oslo from April 2008 to April 2009 were included consecutively in an observational cross-sectional multicentre study. A standardized form was completed by the treating physician, which covered the study aims. All deaths by poisoning in and outside hospitals were registered at the Institute of Forensic Medicine.ResultsThere were 1065 hospital admissions of 912 individuals; 460 (50%) were male, and the median age was 36 years. The annual incidence was 2.0 per 1000. The most frequent toxic agents were ethanol (18%), benzodiazepines (15%), paracetamol (11%), and opioids (11%). Physicians classified 46% as possible or definite suicide attempts, 37% as accidental overdoses with substances of abuse (AOSA), and 16% as other accidents. Twenty-four per cent were discharged without any follow-up and the no follow-up odds were highest for AOSA. There were 117 deaths (eight in hospital), of which 75% were males, and the median age was 41 years. Thus, the annual mortality rate was 25 per 100 000 and the in-hospital mortality was 0.8%. Opioids were the most frequent cause of death.ConclusionsThe incidence of hospitalized acute poisonings in Oslo was similar to that in 2003 and there was an equal sex distribution. Compared with a study performed in Oslo in 2003, there has been an increase in poisonings with a suicidal intention. The in-hospital mortality was low and nine out of ten deaths occurred outside hospitals. Opioids were the leading cause of death, so preventive measures should be encouraged among substance abusers. The number of poisonings caused by paracetamol remained unchanged after the introduction of over-the-counter sales outside pharmacies and there were no deaths, so over-the-counter sales may be considered safe.

Do pre-hospital poisoning deaths differ from in-hospital deaths? A retrospective analysis

“…In the present study, psychoactive pharmaceutical products were the main toxic agent in only 7% of in-hospital and 16% of pre-hospital deaths. According to the present results, the causes of pre-hospital deaths related to pharmaceutical products have similar characteristics as hospital survivors reported in studies from Norway reporting a predominance of opioid and psychoactive pharmaceutical drugs [1, 7]. In the present study, these agents were involved in nearly one-third of pre-hospital deaths and only every sixth in-hospital death.…”

Clinical Effects of Activated Charcoal Unavailability on Treatment Outcomes for Oral Drug Poisoned Patients

“…Nearly half (42%) of patients received the activated charcoal more than 2 hours after exposure to toxins. A Norwegian study reported 16% activated charcoal use for all admitted acute-poisoning patients in Oslo [34, 35]. However, our study also showed a low mortality rate in both the charcoal-available and charcoal-unavailable periods.…”

Acute Intoxications Admitted to Intensive Care Unit: Retrospective Evaluation

“…Norveç'te(28) yapılan çalışmada %0.8 oranında zehirlenmelere bağlı ölüm görülmüştür. Ülkemizde yapılan çalışmalarda akut intokikasyonlara bağlı zehirlenmelerde mortalite %0.9-%9.1 arasında değiştiği saptandı (16,19,22,23,28 …”