Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA.
Am J Emerg Med. 2012 Feb;30(2):293-301. doi: 10.1016/j.ajem.2010.11.031. Epub 2011 Mar 2.
Fatal drug-related poisoning has been well described. However, death data only show the tip of the iceberg of drug-related poisoning as a public health problem. Using the 2007 Nationwide Emergency Department Sample, this study described the characteristics of emergency department visits for drug-related poisoning in the United States.
Any ED visit that had an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of 960-979 was defined as a drug-related poisoning case. Intentionality of poisoning was determined by E-codes. Weighted estimates of ED visits were calculated by patient and hospital characteristics, intentionality of poisoning, and selected drug classes. Population rates by sex, age, urban/rural classification, median household income in patient's zip code, and hospital region were calculated.
An estimated 699 123 (95% confidence interval, 666 529-731 717) ED visits for drug-related poisoning occurred in 2007. Children 0 to 5 years old had the highest rate for unintentional poisoning (male, 237 per 100 000; female, 218 per 100 000). The rate of drug-related poisoning in rural areas (684 per 100 000) was 3 times higher than the rates in other areas. Psychotropic agents and analgesics were responsible for 43.7% of all drug-related poisoning. Women 18 to 20 years old had the highest ED visit rate for suicidal poisoning (245 per 100 000). The estimated ED charges were $1 394 051 262, and 41.1% were paid by Medicaid and Medicare.
Antidepressants and analgesics were responsible for nearly 44% of ED visits for drug-related poisoning in the United States. Interventions and future research should target prescription opioids, rural areas, children 0 to 5 years old for unintentional drug-related poisoning, and female ages 12 to 24 years for suicidal drug-related poisoning.
致命的药物相关中毒已有充分描述。然而，死亡数据仅显示了药物相关中毒作为一个公共卫生问题的冰山一角。本研究利用 2007 年全国急诊抽样调查数据，描述了美国急诊药物相关中毒的特征。
任何国际疾病分类第 9 修订版临床修正诊断代码为 960-979 的急诊就诊均被定义为药物相关中毒。中毒的意图通过 E 代码确定。根据患者和医院特征、中毒意图以及选定的药物类别计算了急诊就诊的加权估计值。按性别、年龄、城乡分类、患者邮政编码所在地区的中位数家庭收入以及医院所在地区计算了人口率。
2007 年，估计有 699123 例（95%置信区间，666529-731717）因药物相关中毒而到急诊就诊。0 至 5 岁的儿童因非故意中毒的发生率最高（男性，每 10 万人 237 例；女性，每 10 万人 218 例）。农村地区（每 10 万人 684 例）药物相关中毒的发生率是其他地区的 3 倍。精神药物和镇痛药导致了所有药物相关中毒的 43.7%。18 至 20 岁的女性因自杀性中毒而到急诊就诊的比率最高（每 10 万人 245 例）。估计急诊费用为 1394051262 美元，其中 41.1%由医疗补助和医疗保险支付。
抗抑郁药和镇痛药导致了美国近 44%的药物相关中毒急诊就诊。干预措施和未来的研究应针对处方类阿片药物、农村地区、0 至 5 岁儿童的非故意药物相关中毒以及 12 至 24 岁女性的自杀性药物相关中毒。
