Muñoz Raúl, Borobia Alberto M, Quintana Manuel, Martínez Ana, Ramírez Elena, Muñoz Mario, Frías Jesús, Carcas Antonio J
Clinical Pharmacology Deparment, Hospital Universitario La Paz, IdiPaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
Clinical Toxicology Unit, Hospital Universitario La Paz, Madrid, Spain.
PLoS One. 2016 Apr 21;11(4):e0152876. doi: 10.1371/journal.pone.0152876. eCollection 2016.
Toxicovigilance is the active process of identifying and evaluating the toxic risks existing in a community, and evaluating the measures taken to reduce or eliminate them.
Through a validated toxicovigilance program (SAT-HULP) we examined the characteristics of acute poisoning cases (APC) attended in the Emergency Department (ED) of La Paz Hospital (Madrid, Spain) and assessed their economic impact on the health system.
The active poisoning surveillance system performs a daily search for cases in the hospital´s computerized case records. Found cases are entered into a database for recording of type of poisoning episode, reasons for exposure, causative agent, signs and symptoms and treatment. We carried out a cross-sectional epidemiological study with analytical projection, based on an impact study on cost per survivor. The data for the costs attributable to cases of APC observed at HULP (outpatients and inpatients) was obtained from the based on the information provided by the diagnosis-related groups (DRG) through the corresponding hospital discharge reports (available through SAT-HULP).
During the first 30 month of SAT-HULP operation we found a total of 3,195 APC, a cumulative incidence rate of 1.75% of patients attended in the ED. The mean (SD) patient age was 40.9 (17.8) years and 51.2% were men. Drug abuse accounted for 47.5% of the cases. Suicide attempt was the second most frequent category (38.1%) and other causes accounted for 14.5% of APC. The total cost of hospital care for our hospital rose to €1,825,263.24 (approximately €730,105.30/year) resulting in a permanent occupation of 4 beds/year.
SAT-HULP constitutes a validated toxicovigilance tool, which continuously integrates available data in real-time and helps health services manage APC data flexibly, including the consumption of resources from the health system.
药物警戒是识别和评估社区中存在的毒性风险，并评估为降低或消除这些风险所采取措施的积极过程。
通过一个经过验证的药物警戒项目（SAT-HULP），我们研究了西班牙马德里拉巴斯医院急诊科收治的急性中毒病例（APC）的特征，并评估了它们对卫生系统的经济影响。
主动中毒监测系统每天在医院的计算机病例记录中搜索病例。发现的病例被录入数据库，记录中毒事件类型、接触原因、致病剂、体征和症状以及治疗情况。我们基于对每位幸存者成本的影响研究，进行了一项带有分析预测的横断面流行病学研究。在HULP（门诊和住院患者）观察到的APC病例的成本数据，是根据诊断相关组（DRG）通过相应的医院出院报告（可通过SAT-HULP获取）提供的信息获得的。
在SAT-HULP运行的前30个月里，我们共发现3195例APC，在急诊科就诊患者中的累积发病率为1.75%。患者的平均（标准差）年龄为40.9（17.8）岁，男性占51.2%。药物滥用占病例的47.5%。自杀未遂是第二常见的类别（38.1%），其他原因占APC的14.5%。我院医院护理的总成本升至1,825,263.24欧元（约合每年730,105.30欧元），导致每年永久性占用4张床位。
SAT-HULP构成了一个经过验证的药物警戒工具，它持续实时整合可用数据，并帮助卫生服务机构灵活管理APC数据，包括卫生系统资源的消耗。
