2004-2017 年澳大利亚与扑热息痛中毒相关的住院治疗和死亡情况。

Paracetamol poisoning-related hospital admissions and deaths in Australia, 2004-2017.

机构信息

NSW Poisons Information Centre, Children's Hospital at Westmead, Sydney, NSW.

University of Sydney, Sydney, NSW.

出版信息

Med J Aust. 2019 Sep;211(5):218-223. doi: 10.5694/mja2.50296. Epub 2019 Aug 6.

DOI:10.5694/mja2.50296

PMID:31389025

Abstract

OBJECTIVES

To assess the numbers of paracetamol overdose-related hospital admissions and deaths in Australia since 2007-08, and the overdose size of intentional paracetamol overdoses since 2004.

DESIGN, SETTING: Retrospective analysis of data on paracetamol-related exposures, hospital admissions, and deaths from the Australian Institute of Health and Welfare National Hospital Morbidity Database (NHMD; 2007-08 to 2016-17), the New South Wales Poisons Information Centre (NSWPIC; 2004-2017), and the National Coronial Information System (NCIS; 2007-08 to 2016-17).

PARTICIPANTS

People who took overdoses of paracetamol in single ingredient preparations.

MAIN OUTCOME MEASURES

Annual numbers of reported paracetamol-related poisonings, hospital admissions, and deaths; number of tablets taken in overdoses.

RESULTS

The NHMD included 95 668 admissions with paracetamol poisoning diagnoses (2007-08 to 2016-17); the annual number of cases increased by 44.3% during the study period (3.8% per year; 95% CI, 3.2-4.6%). Toxic liver disease was documented for 1816 of these patients; the annual number increased by 108% during the study period (7.7% per year; 95% CI, 6.0-9.5%). The NSWPIC database included 22 997 reports of intentional overdose with paracetamol (2004-2017); the annual number increased by 77.0% during the study period (3.3% per year; 95% CI, 2.5-4.2%). The median number of tablets taken increased from 15 (IQR, 10-24) in 2004 to 20 (IQR, 10-35) in 2017. Modified release paracetamol ingestion report numbers increased 38% between 2004 and 2017 (95% CI, 30-47%). 126 in-hospital deaths were recorded in the NHMD, and 205 deaths (in-hospital and out of hospital) in the NCIS, with no temporal trends.

CONCLUSIONS

The frequency of paracetamol overdose-related hospital admissions has increased in Australia since 2004, and the rise is associated with greater numbers of liver injury diagnoses. Overdose size and the proportion of overdoses involving modified release paracetamol have each also increased.

摘要

目的

评估自 2007-08 年以来澳大利亚与扑热息痛过量相关的住院人数和死亡人数，以及自 2004 年以来故意扑热息痛过量的剂量。

设计、地点：对澳大利亚卫生和福利研究所国家医院发病率数据库（NHMD；2007-08 年至 2016-17 年）、新南威尔士毒物信息中心（NSWPIC；2004-2017 年）和国家验尸官信息系统（NCIS；2007-08 年至 2016-17 年）中与扑热息痛相关的暴露、住院和死亡数据进行回顾性分析。

参与者

服用单一成分制剂扑热息痛过量的人。

主要结果测量

报告的扑热息痛相关中毒、住院和死亡人数；过量服用的片剂数量。

结果

NHMD 包括 95668 例扑热息痛中毒诊断的住院患者（2007-08 年至 2016-17 年）；在研究期间，病例数量每年增加 44.3%（每年 3.8%；95%CI，3.2-4.6%）。这些患者中有 1816 例记录了有毒性肝疾病；在研究期间，每年增加 108%（每年 7.7%；95%CI，6.0-9.5%）。NSWPIC 数据库包括 22997 例故意服用扑热息痛过量的报告（2004-2017 年）；在研究期间，每年增加 77.0%（每年 3.3%；95%CI，2.5-4.2%）。服用的片剂中位数从 2004 年的 15（IQR，10-24）增加到 2017 年的 20（IQR，10-35）。2004 年至 2017 年间，控释扑热息痛摄入报告数量增加了 38%（95%CI，30-47%）。NHMD 记录了 126 例院内死亡，NCIS 记录了 205 例（院内和院外）死亡，但没有时间趋势。