Kaeley Nidhi, Bhushan Bharat, Subramanyam Vempalli, Kumar Subodh, Kabi Ankita
Department of Emergency Medicine, AIIMS Rishikesh Campus, Uttrakhand, India.
J Family Med Prim Care. 2019 Feb;8(2):443-448. doi: 10.4103/jfmpc.jfmpc_420_18.
Acute poisoning in geriatric age group is a clinical challenge due to multiple comorbidities and complications in this age group. There are very few studies done in the past, which have addressed this issue.
This retrospective observational study was a carried out in the Department of Emergency Medicine of a tertiary care hospital of Uttarakhand over a period of 1 year from November 2017 to October 2018. Detailed demographic data and clinical history of patients with alleged history of acute poisoning was obtained from the hospital record section.
During the period of 1 year, 156 patients of acute poisoning attended the medical emergency department, of which 53 (33.9%) patients belonged to geriatric age group (>60 years). Maximum number of patients belonged to the age group of 71-80 years ( = 26, 16.6%). Males outnumbered female patients. The most common toxidrome in geriatric age group was alcohol intoxication followed by pesticide (organophosphorus) poisoning. Unintentional exposure of toxin in the form of drug over dosage encompassed more than one-third of poisonings in geriatric population. Nine (16.9%) geriatric patients succumbed to poisoning. Complications such as acute renal failure, shock, respiratory distress, acute liver injury, and need for ventilator support were more common in nonsurvivors as compared with survivors.
The study demonstrated mortality of 16.9% ( = 9) among geriatric patients with alleged history of acute poisoning. The risk factors attributing to mortality were shock, aspiration pneumonia, and acute liver injury. Although cases of suicidal exposure outnumbered cases of unintentional exposure, the latter group comprised of a considerable number. Clearly, more attention is needed while managing a case of acute poisoning of geriatric age group as their pattern of presentation and complications differ from that of younger age group.
由于老年年龄组存在多种合并症和并发症，该年龄组的急性中毒是一项临床挑战。过去针对此问题开展的研究非常少。
这项回顾性观察研究于2017年11月至2018年10月在北阿坎德邦一家三级护理医院的急诊科进行，为期1年。从医院记录科室获取了疑似急性中毒患者的详细人口统计学数据和临床病史。
在1年期间，156例急性中毒患者到医疗急诊科就诊，其中53例（33.9%）患者属于老年年龄组（>60岁）。患者数量最多的年龄组为71 - 80岁（n = 26，16.6%）。男性患者多于女性患者。老年年龄组最常见的中毒综合征是酒精中毒，其次是农药（有机磷）中毒。药物过量形式的毒素意外暴露占老年人群中毒事件的三分之一以上。9例（16.9%）老年患者死于中毒。与幸存者相比，非幸存者中急性肾衰竭、休克、呼吸窘迫、急性肝损伤以及需要呼吸机支持等并发症更为常见。
该研究表明，疑似有急性中毒病史的老年患者死亡率为16.9%（n = 9）。导致死亡的风险因素是休克、吸入性肺炎和急性肝损伤。尽管自杀性暴露病例多于意外暴露病例，但后者数量也相当可观。显然，在处理老年年龄组急性中毒病例时需要更多关注，因为他们的表现形式和并发症与年轻年龄组不同。
