Wang Hsiang-I, Wang Jen-Chun, Chung Chi-Hsiang, Tsai Shih-Hung, Huang Kuang-Hua, Chen Wei Kung, Chien Wu-Chien
Department of Emergency Medicine, Taichung Armed Forces General Hospital, Taichung, 41168, Taiwan, Republic of China.
Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, 11490, Taiwan, Republic of China.
Eur Geriatr Med. 2018 Dec;9(6):819-827. doi: 10.1007/s41999-018-0113-8. Epub 2018 Oct 15.
Older people with dementia are a particularly vulnerable group and have an increased risk of poisoning. We investigated the correlation between dementia and the risk of unintentional poisoning in a retrospective, longitudinal and nationwide population-based study.
Overall, 27,438 patients with dementia were selected from the National Health Insurance Research Database of Taiwan between 1 January 2000 to 31 December 2010, and 109,752 controls were propensity score-matched by gender, age, index year, and presence of heart failure, liver disease, renal disease, and cancers. After adjustment for confounding factors, Cox proportional hazards analysis was used to compare the risk of poisoning during follow-up.
Among dementia patients, 100 (0.36%) had unintentional poisoning events compared to 350 (0.32%) controls. Cox proportional hazards regression revealed that the patients were more likely to develop poisoning than the controls (hazard ratio [HR]: 2.721, 95% CI = 2.162-3.424, p < 0.001). After adjustment for sex, age, monthly income, urbanization level, geographic region, and comorbidities, the HR for poisoning was 2.385 (95% CI = 1.883-3.021, p < 0.001).
Patients with dementia have a high risk of unintentional poisoning, and appropriate prescription medications and careful review of dementia patient compliance are important.
患有痴呆症的老年人是一个特别脆弱的群体，中毒风险增加。我们在一项基于全国人口的回顾性纵向研究中调查了痴呆症与意外中毒风险之间的相关性。
总体而言，从2000年1月1日至2010年12月31日台湾国民健康保险研究数据库中选取了27438例痴呆症患者，并根据性别、年龄、索引年份以及是否存在心力衰竭、肝病、肾病和癌症，对109752名对照进行倾向评分匹配。在对混杂因素进行调整后，使用Cox比例风险分析来比较随访期间的中毒风险。
在痴呆症患者中，有100例（0.36%）发生了意外中毒事件，而对照组为350例（0.32%）。Cox比例风险回归显示，患者比对照组更易发生中毒（风险比[HR]：2.721，95%置信区间[CI]=2.162-3.424，p<0.001）。在对性别、年龄、月收入、城市化水平、地理区域和合并症进行调整后，中毒的HR为2.385（95%CI=1.883-3.021，p<0.001）。
痴呆症患者发生意外中毒的风险很高，合适的处方药以及仔细审查痴呆症患者的依从性很重要。
