奥斯陆致命中毒：一项为期一年的观察性研究。
Fatal poisonings in Oslo: a one-year observational study.
机构信息
Department of Acute Medicine, Oslo University Hospital Ulleval, Kirkeveien 166, N-0407 Oslo, Norway.
出版信息
BMC Emerg Med. 2010 Jun 6;10:13. doi: 10.1186/1471-227X-10-13.
BACKGROUND
Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated.
METHODS
Fatal and non-fatal acute poisonings in subjects aged > or =16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning.
RESULTS
In Oslo, during the one-year period studied, 103 subjects aged > or =16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively.
CONCLUSIONS
Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths. Although case fatality rates were highest for methanol, TCAs, and antihistamines, most deaths were caused by opiates or opioids.
背景
急性中毒很常见，在不同级别的医疗保健系统中进行治疗。由于大多数致命的中毒事件发生在医院之外，因此在研究此类死亡的特征时必须包括这些事件。致命和非致命性中毒的毒物模式不同。通过包括所有中毒事件，可以计算出致死率。
方法
在 2003 年 4 月 1 日至 2004 年 3 月 31 日期间，对奥斯陆（428198 名居民）年龄≥16 岁的所有致命和非致命性急性中毒患者进行了连续观察性多中心研究，包括救护车服务、奥斯陆急诊病房（门诊）和医院，以及法医学尸检。检查了致命性中毒的特征，并比较了致命性和非致命性急性中毒的毒物。
结果
在奥斯陆，在所研究的一年期间，有 103 名年龄≥16 岁的患者死于急性中毒。年死亡率为每 100000 人 24 人。男女比例为 2:1，平均年龄为 44 岁（19-86 岁）。92 例（89%）死亡发生在医院之外。主要毒物为阿片类或类阿片类药物（占病例的 65%），其次为乙醇（9%）、三环类抗抑郁药（TCAs）（4%）、苯二氮䓬类（4%）和唑吡坦（4%）。71 例（69%）被评估为意外死亡，32 例（31%）为自杀。在所有病例中，有 70%（31%的自杀者）的死者被归类为药物或酒精依赖者。与研究期间登记的 2981 例非致命性急性中毒相比，死亡率为 3%（95%CI，0.03-0.04）。甲醇、TCAs 和抗组胺药的死亡率最高，分别为 33%（95%CI，0.008-0.91）、14%（95%CI，0.04-0.33）和 10%（95%CI，0.02-0.27）。
结论
所有急性中毒的 3%为致命性，十分之九的急性中毒死亡发生在医院之外。三分之二被评估为意外死亡。尽管甲醇、TCAs 和抗组胺药的死亡率最高，但大多数死亡是由阿片类或类阿片类药物引起的。
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