Department of Emergency Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Emergency Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #56 Dongsu-ro, Bupyeong-gu, Incheon, Seoul, Republic of Korea.
Aging Clin Exp Res. 2019 Aug;31(8):1139-1146. doi: 10.1007/s40520-018-1053-3. Epub 2018 Oct 22.
Many elderly patients arrive at the emergency department (ED) complaining of deliberate self-poisoning (DSP). This study determined the poisoning severity of elderly patients who committed DSP.
A study was performed with 1329 patients (> 15 years of age) who were treated for DSP at two EDs between January 2010 and December 2016. We classified these patients into two groups based on age (an elderly group ≥ 65 years of age and a nonelderly group). Information was collected on age, sex, cause, ingestion time, drug type, suicide attempt history, initial poisoning severity score (PSS), final PSS, outcome, etc. RESULTS: In total, 242 (18.2%) patients were included in the elderly group, of whom 211 (86.9%) were treated for a first suicide attempt. Admission to the intensive-care unit (ICU) (43.8% vs. 25.5%) and endotracheal intubation (16.1% vs. 4.9%) occurred more frequently in the elderly group than in the nonelderly group (p < 0.001). The frequencies of initial severe PSSs (3 and 4) in the elderly group were 9.1% (N = 22) and 1.2% (N = 3), respectively. Multivariate logistic regression analysis showed that the ICU admission of DSP patients was significantly associated with being elderly (OR of 1.47, 95% CI 1.04-2.09, p = 0.029) and with having a GCS of < 13 (OR of 2.67, 95% CI 1.99-3.57, p < 0.001) and an initial PSS of (3,4) (OR of 3.66, 95% CI 2.14-6.26, p < 0.001). In addition, the presence of underlying diseases (coronary heart disease and cerebrovascular disease) yielded high ORs [(OR of 13.13, 95% CI 2.80-61.57, p = 0.001), (OR of 7.34, 95% CI 1.38-39.09, p = 0.020)].
Elderly patients who visited the ED for DSP exhibited overall more severe PSSs and poorer in-hospital prognosis than did nonelderly DSP patients.
许多老年患者因故意自伤（DSP）到急诊科就诊。本研究旨在确定老年 DSP 患者的中毒严重程度。
对 2010 年 1 月至 2016 年 12 月在两家急诊科接受 DSP 治疗的 1329 名（年龄>15 岁）患者进行了一项研究。我们根据年龄将这些患者分为两组（老年组≥65 岁和非老年组）。收集了年龄、性别、原因、摄入时间、药物类型、自杀未遂史、初始中毒严重程度评分（PSS）、最终 PSS、结局等信息。
共有 242 名（18.2%）患者纳入老年组，其中 211 名（86.9%）为首次自杀未遂。与非老年组相比，老年组 ICU 收治率（43.8% vs. 25.5%）和气管插管率（16.1% vs. 4.9%）更高（p<0.001）。老年组初始严重 PSSs（3 分和 4 分）的发生率分别为 9.1%（N=22）和 1.2%（N=3）。多变量逻辑回归分析显示，DSP 患者 ICU 收治与年龄较大（OR 1.47，95%CI 1.04-2.09，p=0.029）、GCS<13（OR 2.67，95%CI 1.99-3.57，p<0.001）和初始 PSS（3，4）（OR 3.66，95%CI 2.14-6.26，p<0.001）相关。此外，基础疾病（冠心病和脑血管病）的存在也具有较高的 OR 值[（OR 13.13，95%CI 2.80-61.57，p=0.001），（OR 7.34，95%CI 1.38-39.09，p=0.020）]。
与非老年 DSP 患者相比，因 DSP 到急诊科就诊的老年患者整体 PSS 更严重，院内预后更差。
