TRENDS IN INTENTIONAL POISONING PRESENTING TO AN URBAN EMERGENCY DEPARTMENT OVER A FIVE-YEAR PERIOD

Background: Intentional poisonings are a frequent presenting complaint to U.S. emergency departments. The purpose of the current study was to analyze ingestion trends and changes in deliberate self-injury over the last 5 years. Methods: A retrospective chart review of all patients presenting to a regional toxicology referral center with intentional ingestions was performed for two matched time periods (1/93-6/93 and 1/98-6/98). Results: A total of 241 (1993) and 234 (1998) charts met the inclusion criteria (p = 0.42). Admission for medical stabilization was required for 79 patients (32.8%) in 1993 and 90 patients (38.5%) in 1998 (p = 0.01). The average length of stay was 2.51 days in 1993 compared to 2.91 days in 1998 (p = 0.48). The average intensive care unit lengths of stay were 0.67 days and 0.89 days respectively (p = 0.56). No patient died during either time period. In descending order of frequency, the most commonly ingested substances in 1993 were benzodiazepines, combination analgesics, non-steroidal anti-inflammatory drugs, over-the-counter cold preparations, and tricyclic antidepressants (TCA). In 1998 the 5 most common substances were benzodiazepines, acetominophen, combination analgesics, TCAs, and anti-epileptic medications. An analysis of all 33 drug categories showed no change in ingestion profile during the study period (p = 0.37). Conclusion: There has been no statistically significant change in the number of presenting patients, admission or ICU days, nor in profile of agents used in intentional ingestions. However, there was a statistically significant increase in the number of patients admitted between 1993 and 1998.
Sztajnkrycer MD, Gesell LB, Dewan N. Departments of Emergency Medicine and Psychiatry, University Hospital, Cincinnati, [...]