Self-poisoning: current trends and practice in a UK teaching hospital

Abstract

-The epidemiology of deliberate selfpoisoning presentations to the emergency department (ED) of Ninewells Hospital was reviewed over a six-month period. The results were related to previously published Scottish data. During the six month period, 530 patients presented (2.1% of total). There was a female preponderance with over 65% of patients aged less than 40 years. Patients lived more commonly in areas of higher deprivation. The drugs most commonly involved were paracetamol (39.25%) and antidepressants (35.1%). Of the presentatons 80.2% required no treatment apart from basic observations. Only 1.51% received activated charcoal and no gastric lavages were performed. Of the presentations, 75.6% were discharged after observation in the ED, 8.9% were admitted to a psychiatric hospital and 5.5% were admitted to general medicine department. Deliberate self-poisoning continues to be a major cause of hospital admissions in Scotland. In Tayside, it is predominantly a problem of the young and socially deprived. Consistent with recent national trends, paracetamol was the most common drug relating to overdose. The use of an ED observation ward is supported as a vast majority of patients are admitted for less than 24 hours and require no active treatment.

Changes in poisonings among adolescents in the UK between 1992 and 2012: a population based cohort study

“…Overall, we found a higher incidence of poisoning in females than in males, which is consistent with the existing literature 4 8 10 15 18 21 32. Total and intentional poisonings increasing with age has also been shown previously,4 13 21 32 but this is the first study showing age specific poisoning rates for each poisoning intent separately to assess how more specific age patterns vary among adolescents.…”

Acute intoxication patients presenting to an emergency department in the Netherlands: admit or not? Prospective testing of two algorithms

“…Mean±SD age was 34.4±13.2 (range 14–81) years. Most intoxication patients (62.8%) were women, as was found in other studies 9 22 23. Most cases were suicide attempts (68.6%).…”

“…In the group of antidepressants, selective serotonin reuptake inhibitors formed the major subgroup. Compared with the international literature, tricyclic antidepressants were less prevalent 22 23…”

Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU

“…From 1999 to 2008, hospitalization rates for overdose in USA increased by 55%, costing about US$737 million in 2008 [10]. Patients with acute drug intoxication represent 0.6–2.1% of all ED visits [11,12], and account for 3–14% of total Intensive Care Unit (ICU) admissions [13–16]. In the Western hemisphere, both ICU and in-hospital mortality of patients with acute drug intoxication are significantly lower than that of the general ICU population, at 0.2–4% [16,17].…”