Gunnell D, Ho D, Murray V
Department of Social Medicine, Bristol University, Bristol, UK.
Emerg Med J. 2004 Jan;21(1):35-8. doi: 10.1136/emj.2003.000935.
Overdoses account for a quarter of all suicides in England. The number of people who survive the immediate effects of their overdose long enough to reach medical attention, but who subsequently die in hospital is unknown. The aim of this study was to determine the proportion of overdose suicides dying in hospital and describe their sociodemographic characteristics.
Cross sectional analysis of routinely collected Hospital Episode Statistics data for England (1997 to 1999) to identify hospital admissions for overdose among people aged 12+ and the outcome of these admissions.
Between 1997 and 1999 there were 233 756 hospital admissions for overdose, 1149 (0.5%) of these ended in the death of the patient such deaths accounted for 28% [corrected] of all overdose suicides and 8% [corrected] of total suicides. The median time between admission and death was three days (interquartile range one to nine days). The most commonly identified drugs taken in fatal overdose were paracetamol compounds, benzodiazepines, and tricyclic/tetracyclic antidepressants.
Around a quarter of all overdose suicide deaths occur subsequent to hospital admission. Further more detailed research is required to discover if better pre-admission and in-hospital medical management of those taking serious overdoses may prevent some of these deaths.
在英格兰，药物过量致死占所有自杀案例的四分之一。那些在药物过量的直接影响中存活足够长时间得以就医，但随后在医院死亡的人数尚不清楚。本研究的目的是确定药物过量自杀者在医院死亡的比例，并描述他们的社会人口学特征。
对英格兰常规收集的医院事件统计数据（1997年至1999年）进行横断面分析，以确定12岁及以上人群因药物过量导致的住院情况以及这些住院病例的结局。
1997年至1999年期间，有233756例因药物过量导致的住院病例，其中1149例（0.5%）以患者死亡告终，这些死亡病例占所有药物过量自杀案例的28%[校正后]，占总自杀案例的8%[校正后]。入院至死亡的中位时间为三天（四分位间距为一天至九天）。致命药物过量中最常涉及的药物是对乙酰氨基酚类化合物、苯二氮䓬类药物和三环/四环抗抑郁药。
所有药物过量自杀死亡案例中约有四分之一发生在入院之后。需要进行更详细的研究，以确定对严重药物过量者更好的院前和院内医疗管理是否可以预防其中一些死亡。
