Coleridge J, Cameron P A, Drummer O H, McNeil J J
Emergency Department, Western Hospital, Footscray, VIC.
Med J Aust. 1992 Oct 5;157(7):459-62. doi: 10.5694/j.1326-5377.1992.tb137307.x.
To audit drug-related deaths to determine the types of agents causing death in Victoria and to identify possible strategies for prevention of deaths in future.
Retrospective audit of Coroner's case records.
All deaths reported to the Coroner during 14 months from 1 July 1989 to 31 August 1990 in Victoria in which toxicological investigation was undertaken and drugs or poisons were detected and were believed to be a major cause of death.
Of the 231 people who had drug-related deaths, 156 were males, 75 were females and the average age was 35.5 +/- 14 years. Heroin and morphine were judged to be the primary cause of death in 35% of subjects and methadone in a further 4.8%. Tricyclic antidepressants were responsible for 14% of deaths, with no deaths due solely to mianserin. Benzodiazepines were the prime cause of death in 6.5% of subjects, but were identified in 40%. Poisons and chemicals were involved in only 3% of deaths. Prescription drugs were primarily responsible for 47% of deaths. Forty-eight per cent of deaths occurred in known injecting drug users and 42% of all subjects had a clear history of antecedent depression. Only one drug-related death was clearly accidental, that of a two-year-old child taking his parents' medications, but the mode of most deaths was not clear, and may not have been suicide. Most deaths occurred outside hospital, only 25 subjects reaching hospital alive.
Barbiturates and chloral hydrate are no longer major causes of drug-related deaths, probably because of decreased availability. Some drug-related deaths, especially those related to tricyclic antidepressants, may be prevented if deaths and hospitalisations due to toxic substances are monitored and the availability and scheduling of toxic substances are regularly reviewed.
审核与药物相关的死亡病例，以确定在维多利亚州导致死亡的药物种类，并找出未来预防死亡的可能策略。
对验尸官案件记录进行回顾性审核。
1989年7月1日至1990年8月31日这14个月期间向维多利亚州验尸官报告的所有死亡病例，这些病例均进行了毒理学调查，检测出药物或毒物，且被认为是主要死因。
在231例与药物相关的死亡病例中，男性156例，女性75例，平均年龄为35.5±14岁。海洛因和吗啡被判定为35%的病例的主要死因，美沙酮导致的死亡病例占4.8%。三环类抗抑郁药导致了14%的死亡，米安色林单独导致的死亡病例为零。苯二氮䓬类药物是6.5%的病例的主要死因，但在40%的病例中被检测到。毒物和化学品仅导致了3%的死亡。处方药是47%的死亡病例的主要原因。48%的死亡病例发生在已知的注射吸毒者中，42%的病例有明确的既往抑郁病史。只有1例与药物相关的死亡明显是意外，即一名两岁儿童误服了父母的药物，但大多数死亡方式不明，可能并非自杀。大多数死亡发生在医院外，只有25例患者活着被送往医院。
巴比妥类药物和水合氯醛不再是与药物相关的死亡的主要原因，可能是因为其可获得性降低。如果对有毒物质导致的死亡和住院情况进行监测，并定期审查有毒物质的可获得性和处方规定，一些与药物相关的死亡，尤其是与三环类抗抑郁药相关的死亡可能会得到预防。
