Cincinnati Children's Hospital, Emergency Medicine, Cincinnati, OH, USA.
Clin Toxicol (Phila). 2010 Jan;48(1):64-7. doi: 10.3109/15563650903397234.
As no "gold standard" measure exists for the number of children evaluated in emergency departments (EDs) for medication-related injuries, the public health impact is based on estimates. In January 2006 the Morbidity and Mortality Weekly Report published a National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) estimate on unintentional pediatric medication exposure to children < or =4 years of age that resulted in an ED visit: 53,517 per year for the period 2001-2003. We sought to generate a parallel estimate using American Association of Poison Control Centers' (AAPCC) National Poison Data System (NPDS) to see how these estimates compare.
To match data reported from the NEISS-AIP, NPDS was searched for the electronic medical records of children < or =4 years of age whose call type was an unintentional exposure to a pharmaceutical that involved presenting to a health care facility (HCF) in 2001-2003.
178,513 met all of the criteria: 57,100 in 2001; 60,098 in 2002; and 61,315 in 2003. Comparing NEISS-AIP to NPDS: 10% versus 13% were hospitalized; 72% versus 68% were either 1 or 2 years of age; and the substance distribution was acetaminophen (8.1%, 6.8%), cough/cold (7.5%, 9.6%), cardiovascular (7.8%, 11.0%), anticonvulsant (3.6%, 3.2%), and vitamins (4.5%, 3.4%).
These results are close suggesting that the actual number is near these numbers. The NPDS number is greater than NEISS-AIP point estimate but within the 95% confidence interval. As NPDS is an actual count and NEISS-AIP is an extrapolation from a sample, to the extent that every child presenting to an ED following a medication exposure is not reported to a poison center, both databases may underestimate the problem. The NEISS-AIP extrapolation tool may need to be reassessed.
由于目前尚不存在评估急诊科（ED）中因药物相关伤害而接受评估的儿童人数的“金标准”方法，因此公共卫生影响是基于估计得出的。2006 年 1 月，《发病率和死亡率周报》发表了国家电子伤害监测系统-所有伤害项目（NEISS-AIP）对 2001-2003 年期间 4 岁以下儿童非故意药物暴露导致 ED 就诊的估计值：每年 53517 例。我们试图使用美国中毒控制中心协会（AAPCC）国家毒物数据系统（NPDS）生成一个平行估计值，以了解这些估计值的差异。
为了匹配 NEISS-AIP 报告的数据，NPDS 搜索了 2001-2003 年期间年龄在 4 岁以下的儿童的电子病历，其呼叫类型为非故意药物暴露并涉及到医疗保健机构（HCF）就诊。
178513 例符合所有标准：2001 年 57100 例；2002 年 60098 例；2003 年 61315 例。将 NEISS-AIP 与 NPDS 进行比较：住院率分别为 10%和 13%；72%和 68%为 1 或 2 岁；药物分布为对乙酰氨基酚（8.1%，6.8%）、咳嗽/感冒（7.5%，9.6%）、心血管（7.8%，11.0%）、抗惊厥药（3.6%，3.2%）和维生素（4.5%，3.4%）。
这些结果非常接近，表明实际数量接近这些数字。NPDS 数量大于 NEISS-AIP 点估计值，但在 95%置信区间内。由于 NPDS 是实际计数，而 NEISS-AIP 是从样本中推断出来的，因此，每个因药物暴露而到 ED 就诊的儿童并非都向中毒控制中心报告，这两个数据库都可能低估了问题。可能需要重新评估 NEISS-AIP 外推工具。
