Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, USA.
Suicide Life Threat Behav. 2019 Jun;49(3):635-642. doi: 10.1111/sltb.12468. Epub 2018 Apr 25.
There are limited data on the medical severity of suicide attempts by intentional self-poisoning (ISP) associated with ingestion of differing classes of medications and meager data on specific agents. The purpose of the study was to address these gaps. This was an analysis of a consecutive series of ISP cases ages 13 to 65 treated at a U.S. university medical center (N = 671). The outcome, poisoning severity, was dichotomized as "moderate-severe" and "low" (reference) based on a standard measure. Class of medication (e.g., opiate) and specific agents ingested were the predictors of interest. Covariates were age, sex, and the ingestion of multiple classes of medications. Data were analyzed using multivariate logistic regression models. At the class level, ingestion of opiate was uniquely associated with increased risk for moderate-severe ISP at a statistically significant level, adjusted odds ratio (95% CI) = 2.97 (1.69, 5.21), p = .0002. Several specific agents were also associated with moderate-severe ISP. Along with the key role of opiate medications in unintentional overdose morbidity and mortality, opiate medications may also play an important and largely unrecognized role in medically serious suicidal behavior. Results also underscore the variability in toxicity of specific agents within drug classes.
关于因摄入不同类别的药物而故意自我中毒（ISP）导致的自杀未遂的医学严重程度的数据有限，关于特定药物的数据则更少。本研究旨在解决这些空白。这是对美国大学医疗中心（N=671）连续收治的 ISP 病例（年龄 13 至 65 岁）的分析。根据一项标准衡量标准，将结果（中毒严重程度）分为“中度-重度”和“轻度”（参考）。关注的预测因素是药物类别（如阿片类药物）和摄入的特定药物。协变量为年龄、性别和摄入多种类别的药物。使用多变量逻辑回归模型分析数据。在药物类别水平上，阿片类药物的摄入与中度-重度 ISP 的风险增加具有统计学意义，调整后的优势比（95%置信区间）=2.97（1.69, 5.21），p=0.0002。一些特定的药物也与中度-重度 ISP 有关。除了阿片类药物在非故意药物过量发病率和死亡率中的关键作用外，阿片类药物在严重的自杀行为中可能也扮演着重要但很大程度上被忽视的角色。结果还强调了特定药物在药物类别内的毒性差异。
