Division of Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD 20993, USA.
Pharmacoepidemiol Drug Saf. 2011 Aug;20(8):819-26. doi: 10.1002/pds.2090. Epub 2011 Feb 3.
To estimate the number of acetaminophen overdose-related emergency department (ED) visits and hospitalizations in the United States, characterize these by intentionality, age, and gender, and compare the strengths and limitations of the utilized databases.
We used data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) and the National Electronic Injury Surveillance System (NEISS) to estimate the number of relevant ED visits in the United States between 2000 and 2007, and the National Hospital Discharge Survey (NHDS) to estimate the number of relevant hospitalizations in the United States between 1991 and 2006. National estimates and their standard errors were calculated using information provided in each database. We used the standard United States population in 2000 to calculate age-adjusted rates.
We estimate an annual average of 44,348 (NHAMCS, 2000-2007) or 78,414 (NEISS, 2006-2007) acetaminophen overdose-related ED visits and 33,520 (NHDS, 2000-2006) hospitalizations. For 2000-2006 we calculated an age-adjusted rate of 13.9 acetaminophen overdose-related hospitalizations per 100,000 US population, with the highest rate (15.7) occurring from 2005 to 2006. Between 1991 and 2006, there was no decrease noted in hospitalizations for intentional or unintentional overdoses. The majority of overdoses reported in NEISS (69.8%) and NHDS (74.2%) were classified as intentional (suicides or suicidal gestures), whereas in NHAMCS, intentionality was evenly distributed.
Our results suggest that acetaminophen overdose, both intentional and unintentional, remains a significant public health concern. With an understanding of their methodological characteristics and limitations, these national databases can be useful tools to characterize acetaminophen overdose-related ED visits and hospitalizations.
估计美国与对乙酰氨基酚过量相关的急诊就诊和住院人数，根据意图、年龄和性别对这些数据进行特征描述，并比较所使用数据库的优缺点。
我们使用了来自国家医院门诊医疗调查（NHAMCS）和国家电子伤害监测系统（NEISS）的数据，来估计 2000 年至 2007 年期间美国因对乙酰氨基酚过量而导致的相关急诊就诊人数，使用国家医院出院调查（NHDS）来估计 1991 年至 2006 年期间美国因对乙酰氨基酚过量而导致的相关住院人数。利用每个数据库中提供的信息，计算全国性估计数及其标准误差。我们使用 2000 年的美国标准人口来计算年龄调整率。
我们估计每年平均有 44348 例（NHAMCS，2000-2007 年）或 78414 例（NEISS，2006-2007 年）与对乙酰氨基酚过量相关的急诊就诊，以及 33520 例（NHDS，2000-2006 年）与对乙酰氨基酚过量相关的住院治疗。我们计算出，2000-2006 年，每 10 万美国人口中有 13.9 例与对乙酰氨基酚过量相关的住院治疗被调整为年龄因素，从 2005 年至 2006 年的比率最高（15.7）。1991 年至 2006 年，与故意或非故意过量相关的住院人数没有减少。在 NEISS（69.8%）和 NHDS（74.2%）报告的大多数过量中，意图被归类为故意（自杀或自杀行为），而在 NHAMCS 中，故意和非故意的比例则大致相当。
我们的研究结果表明，故意和非故意的对乙酰氨基酚过量仍然是一个严重的公共卫生问题。了解这些全国性数据库的方法学特征和局限性，可以将其作为有用的工具，来对与对乙酰氨基酚过量相关的急诊就诊和住院治疗进行特征描述。
