Gedeborg Rolf, Svennblad Bodil, Holm Lennart, Sjögren Hans, Bardage Carola, Personne Mark, Sjöberg Gunilla, Feltelius Nils, Zethelius Björn
Department of Scientific Expertise, Medical Products Agency, Uppsala, Sweden.
Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
Pharmacoepidemiol Drug Saf. 2017 May;26(5):518-527. doi: 10.1002/pds.4166. Epub 2017 Jan 13.
To estimate the incidence trend and outcome of paracetamol poisoning, in relation to increased availability of paracetamol from non-pharmacy outlets in 2009.
Patients' serum paracetamol results over 14 years (2000-2013) from 20 (out of 21) regions in Sweden were linked to national registers of hospital care, cause of death, and prescriptions. Paracetamol poisonings were defined by serum paracetamol levels, hospital diagnoses, or cause of death. The change in incidence of poisonings following increased availability of paracetamol was analysed by using segmental regression of time series.
Of the 12 068 paracetamol poisonings, 85% were classified as intentional self-harm. Following increased availability from non-pharmacy outlets, there was a 40.5% increase in the incidence of paracetamol poisoning, from 11.5/100 000 in 2009 to 16.2/100 000 in 2013. Regression analyses indicated a change in the trend (p < 0.0001) but not an immediate jump in the incidence (p = 0.5991) following the increased availability. Adjusting for trends in hospital episodes for self-harm, suicides, and the sales volume of paracetamol did not influence the result. All-cause mortality at 30 days (3.2%) did not change over time.
The incidence of paracetamol poisoning in Sweden has increased since 2009, contrasting the decreased incidence in the period of 2007-2009. The change in trend was temporally associated with the introduction of availability of paracetamol from non-pharmacy outlets but did not appear to be related to sales volume of paracetamol or general trends in self-harm or suicides. © 2017 Commonwealth of Australia. Pharmacoepidemiology and Drug Safety © 2017 John Wiley & Sons, Ltd.
评估对乙酰氨基酚中毒的发病率趋势及转归，与2009年非药店渠道对乙酰氨基酚可及性增加的情况相关。
瑞典21个地区中的20个地区14年（2000 - 2013年）患者的血清对乙酰氨基酚检测结果与国家医院护理、死亡原因及处方登记信息相联系。对乙酰氨基酚中毒由血清对乙酰氨基酚水平、医院诊断或死亡原因来定义。通过时间序列分段回归分析对乙酰氨基酚可及性增加后中毒发病率的变化。
在12068例对乙酰氨基酚中毒病例中，85%被归类为故意自我伤害。非药店渠道对乙酰氨基酚可及性增加后，对乙酰氨基酚中毒发病率增加了40.5%，从2009年的11.5/10万增至2013年的16.2/10万。回归分析表明趋势发生了变化（p < 0.0001），但可及性增加后发病率并未立即跃升（p = 0.5991）。对自我伤害、自杀的医院就诊趋势及对乙酰氨基酚销量进行校正，并不影响结果。30天全因死亡率（3.2%）未随时间变化。
自2009年以来，瑞典对乙酰氨基酚中毒的发病率有所上升，这与2007 - 2009年期间发病率下降形成对比。趋势变化在时间上与非药店渠道引入对乙酰氨基酚可及性相关，但似乎与对乙酰氨基酚销量或自我伤害及自杀的总体趋势无关。© 2017澳大利亚联邦。药物流行病学与药物安全 © 2017约翰·威利父子有限公司。
