Pichot M H, Auzépy P, Richard C
Service de Réanimation Médicale, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
Ann Med Interne (Paris). 1990;141(5):429-30.
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.
自杀性老年患者的自我急性药物过量似乎对公共卫生构成了日益严峻的挑战。据我们所知，关于这一主题的文献报道很少。因此，我们于1969年1月至1989年10月在一家医疗重症监护病房进行了一项回顾性研究。纳入了92名自杀性老年患者（54名女性，38名男性），平均年龄为77岁。平均住院时间为7天（范围：1 - 45天）。其中76%的患者接受了插管并进行机械通气，平均持续时间为3天。46例（50%）患者服用了一种药物过量。毒理学分析涉及以下药物：苯二氮䓬类，50例；眠尔通，26例；巴比妥类，24例；三环类抗抑郁药，17例；三氯乙烯，1例；胰岛素，1例。记录了47例患者的精神病史，其中20例曾有过自杀未遂史。40例（43.5%）报告了并发症：呼吸并发症，25例；休克，13例；缺氧后昏迷，2例。死亡率（13例）为14%。33例患者在从重症监护病房出院后被转至精神科。在同一时期，我们的重症监护病房收治了2762例急性药物中毒患者，观察到死亡率为1%。因此，老年人的发病率和死亡率高于年轻患者。
