院前中毒死亡与院内死亡有差异吗？一项回顾性分析。
Do pre-hospital poisoning deaths differ from in-hospital deaths? A retrospective analysis.
作者信息
Koskela Lauri, Raatiniemi Lasse, Bakke Håkon Kvåle, Ala-Kokko Tero, Liisanantti Janne
机构信息
Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, P.O. BOX 21, 90029 OYS, Oulu, Finland.
Medical Research Center, Study Group of Surgery, Anesthesiology and Intensive Care, Oulu University, Oulu, Finland.
出版信息
Scand J Trauma Resusc Emerg Med. 2017 May 8;25(1):48. doi: 10.1186/s13049-017-0391-z.
BACKGROUND
Most fatal poisonings occur outside the hospital and the victims found dead. The purpose of this study was to determine the general pattern and patient demographics of fatal poisonings in Northern Finland. In particular, we wanted to analyze differences between pre-hospital and in-hospital deaths.
METHODS
All fatal poisonings that occurred in Northern Finland in 2007-2011 were retrieved from the Cause of Death Registry provided by Statistics Finland. We noted the patient demographics, causal agents, and other characteristics of the poisoning events.
RESULTS
A total of 689 fatal poisonings occurred during the study period, of which only 42 (6.1%) reached the hospital alive. Those who died pre-hospital were significantly younger (50 vs. 56 years, p = 0.04) and more likely to be male (77% vs. 57%, p = 0.003). Cardiopulmonary resuscitation was attempted less often in pre-hospital cases (9.9% vs. 47.6%, p < 0.001). Ethanol was more frequently the main toxic agent in pre-hospital deaths (58.4% vs. 26.2%, p < 0.001), and multiple ingestions were more common (52.2% vs. 35.7%, p < 0.001) in pre-hospital deaths.
DISCUSSION
Most of the pre-hospital fatal poisoning victims are found dead and the majority of in-hospital victims are admitted to hospital in an already serious condition. According to results of this and former studies, prevention seems to be the most important factor in reducing deaths due to poisoning.
CONCLUSIONS
The majority of poisoning-related deaths occur pre-hospital and are related to alcohol intoxication and multiple ingestions.
背景
大多数致命中毒事件发生在医院外，受害者被发现死亡。本研究的目的是确定芬兰北部致命中毒事件的总体模式和患者人口统计学特征。特别是，我们想分析院前死亡和院内死亡之间的差异。
方法
从芬兰统计局提供的死亡原因登记处检索2007年至2011年在芬兰北部发生的所有致命中毒事件。我们记录了患者的人口统计学特征、致病因素以及中毒事件的其他特征。
结果
在研究期间共发生了689起致命中毒事件，其中只有42例（6.1%）活着到达医院。院前死亡者明显更年轻（50岁对56岁，p = 0.04），且男性比例更高（77%对57%，p = 0.003）。院前病例尝试心肺复苏的频率较低（9.9%对47.6%，p < 0.001）。乙醇在院前死亡中更常是主要有毒物质（58.4%对26.2%，p < 0.001），且院前死亡中多次摄入更常见（52.2%对35.7%，p < 0.001）。
讨论
大多数院前致命中毒受害者被发现死亡，而大多数院内受害者入院时病情已很严重。根据本研究和以前研究的结果，预防似乎是减少中毒死亡的最重要因素。
结论
大多数与中毒相关的死亡发生在院前，且与酒精中毒和多次摄入有关。
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