[Acute drug poisoning in suicidal elderly patients 70 years' old and over. 92 cases in a medical ICU].

Self-inflicted acute drug overdose in suicidal elderly patients appears to be a growing challenge to public health. To the best of our knowledge, little has been published on this topic. Thus we undertook a retrospective study, from January 1969 to October 1989, in a medical ICU. Ninety-two suicidal, elderly patients (54 women, 38 men) with a mean age of 77 years were included. The mean length of the hospital stay was 7 days (range: 1-45 days). Seventy-six percent of them were intubated and subjected to mechanical ventilation for a mean duration of 3 days. Overdosing on one drug occurred in 46 cases (50%). Toxicological analyses implicated the following medications: benzodiazepines, 50 cases; meprobamate, 26 cases; barbiturates, 24 cases; tricyclic anti-depressants, 17 cases; trichloroethylene, 1 case; insulin, 1 case. Psychiatric history, recorded for 47 patients, revealed previous suicide attempts by 20 of them. Complications were reported in 40 cases (43.5%): respiratory complications, 25 cases; shock, 13 cases; postanoxic coma, 2 cases. The incidence of mortality (13 cases) was 14%. Thirty-three patients were transferred to psychiatric units after release from ICU. During the same period, our ICU admitted 2,762 patients for acute drug poisoning and observed a 1% mortality rate. Thus, morbidity and mortality are higher in the elderly than in younger patients.