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台湾地区中毒事件发生率及患者结局:一项基于全国人口的观察性研究。

Incidence of intoxication events and patient outcomes in Taiwan: A nationwide population-based observational study.

机构信息

Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

PLoS One. 2020 Dec 23;15(12):e0244438. doi: 10.1371/journal.pone.0244438. eCollection 2020.

Abstract

BACKGROUND

Intoxicated patients were frequently managed in the emergency departments (ED) with few studies at national level. The study aimed to reveal the incidence, outcomes of intoxications and trend in Taiwan.

METHODS

Adults admitted to an ED due to an intoxication event between 2006 and 2013 were identified using the Taiwan National Health Insurance Research Database. The rate of intoxication and severe intoxication events, mortality rate, hospital length of stay (LOS), and daily medical costs of these patients were analyzed. Changes over time were analyzed using Joinpoint models. Multivariable generalized regressions with GEE were used to assess the effect of sex, age, and presence of prior psychiatric illness.

RESULTS

A total of 20,371 ED admissions due to intoxication events were identified during the study period, and the incidence decreased with annual percentage change of 4.7% from 2006 to 2013. The mortality rate, hospital LOS, and daily medical costs were not decreased over time. Males and geriatric patients had more severe intoxication events, greater mortality rates, and greater daily medical costs. Patients with psychiatric illnesses had higher mortality rates and a longer hospital LOS, but lower daily medical expenses.

CONCLUSION

From 2006 to 2013, there was a decline in the incidence of ED admission for intoxication events in Taiwan. Males, geriatric patients, and those with psychiatric illnesses had greater risks for severe intoxication and mortality.

摘要

背景

在急诊部门(ED)经常会有醉酒患者就诊,但在全国范围内对此进行的研究较少。本研究旨在揭示台湾地区中毒事件的发生率、结局和趋势。

方法

利用台湾全民健康保险研究数据库,确定了 2006 年至 2013 年期间因中毒事件而入住 ED 的成年人。分析了这些患者的中毒和重度中毒事件发生率、死亡率、住院时间(LOS)和每日医疗费用。使用 Joinpoint 模型分析随时间的变化。使用广义估计方程(GEE)的多变量回归分析评估了性别、年龄和既往精神疾病存在的影响。

结果

在研究期间共确定了 20371 例因中毒事件而入住 ED 的病例,发病率从 2006 年到 2013 年以每年 4.7%的速度下降。死亡率、住院 LOS 和每日医疗费用并未随时间而降低。男性和老年患者更易发生重度中毒事件、更高的死亡率和更高的每日医疗费用。有精神疾病的患者死亡率更高,住院时间更长,但每日医疗费用较低。

结论

2006 年至 2013 年期间,台湾因中毒事件而入住 ED 的发生率下降。男性、老年患者和有精神疾病的患者发生重度中毒和死亡的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4628/7757892/fae3f957b0a9/pone.0244438.g001.jpg

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