Department of Veterans Affairs, HSR&D COE and SMITREC, University of Michigan Medical School, Ann Arbor, MI 48104, USA.
Med Care. 2011 Apr;49(4):393-6. doi: 10.1097/MLR.0b013e318202aa27.
Accidental poisoning mortality is an increasingly important concern, particularly for health systems, which distribute potentially poisoning medications and treat substance use disorders.
To describe the rate of accidental poisoning mortality in the Veterans Health Administration (VHA) during fiscal year 2005, assess differences with rates observed in the general US population, and describe the frequency with which specific drugs and medications were mentioned on the death records of accidental poisoning decedents.
Cohort study.
All 5,567,621 individuals aged 18+ who received VHA inpatient or outpatient services in fiscal year 2004 (October 1, 2003 to September 30, 2004) or fiscal year 2005 and were alive at the start of fiscal year 2005.
The National Death Index indicated vital status and cause of death, the National Patient Care Database indicated who used VHA services and consequently was in the study cohort, and the Web-based Injury Statistics Query and Reporting System indicated poisoning mortality rates in the general US population.
The crude rate of accidental poisoning mortality in the VHA for fiscal year 2005 was 19.85 deaths per 100,000 person-years. After accounting for gender and age distribution, VHA patients had nearly twice the rate of fatal accidental poisoning compared with adults in the general US population (standardized mortality ratio=1.96; 95% confidence interval: 1.83, 2.08). Opioid medications and cocaine were frequently mentioned as the agents causing poisoning on death records.
The present work indicates that a substantial need exists for interventions to reduce the risk of accidental poisoning among VHA patients.
意外中毒死亡率是一个日益受到关注的问题，尤其是对医疗系统而言，因为医疗系统分发可能导致中毒的药物并治疗物质使用障碍。
描述 2005 财年退伍军人健康管理局（VHA）中意外中毒死亡率的比率，评估其与美国普通人群观察到的比率的差异，并描述在意外中毒死亡者的死亡记录中提到的特定药物和药物的频率。
队列研究。
2004 财年（2003 年 10 月 1 日至 2004 年 9 月 30 日）或 2005 财年接受 VHA 住院或门诊服务且在 2005 财年开始时存活的所有 18 岁及以上的 5567621 人。
国家死亡指数表明生命状态和死因，国家患者护理数据库表明谁使用了 VHA 服务，因此在研究队列中，基于网络的伤害统计查询和报告系统表明美国普通人群中毒死亡率。
2005 财年 VHA 意外中毒死亡率的粗率为每 10 万人年 19.85 例死亡。在考虑性别和年龄分布后，与美国普通成年人相比，VHA 患者的致命意外中毒率几乎高出两倍（标准化死亡率比=1.96；95%置信区间：1.83，2.08）。在死亡记录上，阿片类药物和可卡因经常被提及是导致中毒的原因。
目前的工作表明，退伍军人健康管理局的患者存在大量需要采取干预措施来降低意外中毒风险。
