Jensen Thomas Leth, Tejlbo Frost Matilde, Dalhoff Kim, Studsgaard Petersen Tonny
Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Clin Toxicol (Phila). 2023 May;61(5):392-399. doi: 10.1080/15563650.2023.2205006. Epub 2023 May 12.
Poisonings contribute significantly to morbidity and mortality of patients. Some patients have numerous contacts to a poison information center, indicating repeated poisoning exposures. Information on the involved substances is necessary to explore methods to prevent self-harm and reduce mortality. The objective of this study was to characterize the patient population with repeated poison exposures in Denmark and identify the substances involved.
This study was a retrospective cohort study of enquiries to the nationwide Danish Poison Information Centre and the Danish National Patient Registry. The databases were used to identify patients with more than five individual poisoning episodes within a 12-month-period between 1 January 2013, and 31 December 2017.
One hundred and thirty-seven patients and 995 patients met the inclusion criteria in the Danish Poison Information Centre and the Danish National Patient Registry, respectively. The majority were women (82.5% and 66.3% for the Danish Poison Information Centre and the Danish National Patient Registry cohorts, respectively). The mean age was 24.7 and 29.5 years. Psychiatric comorbidities were frequent with 74.5% and 67.0% suffering from personality disorders and 70.1% and 54.5% from affective disorders in the Danish Poison Information Centre and the Danish National Patient Registry cohorts, respectively. One thousand seven hundred and fifty-two poisoning episodes were identified in the Danish Poison Information Centre database, and the most common types of substance were 'pharmaceuticals' (1,420 episodes). The most common medications ingested were quetiapine, paracetamol and cyclizine. Median number of contacts to the Danish Poison Information Centre was 10. Patients with one or more poisoning episodes involving cyclizine had on average 11.4 poisoning episodes involving cyclizine. In the Danish National Patient Registry cohort 80.9% were alive after 10 years compared to 97.7% in the background population.
Most poisonings were intentional and occurred among younger women. Psychiatric comorbidity was frequent. Most often, pharmaceuticals were the toxic substance, mainly quetiapine, paracetamol and cyclizine. Changing the status of cyclizine from over the counter to prescription only medication, and implementing stricter rules for prescribing quetiapine, could limit future poisoning incidences.
中毒对患者的发病率和死亡率有重大影响。一些患者多次联系毒物信息中心，表明存在反复的中毒暴露。了解所涉物质的信息对于探索预防自我伤害和降低死亡率的方法至关重要。本研究的目的是描述丹麦反复中毒暴露患者群体的特征，并确定所涉物质。
本研究是一项对丹麦全国毒物信息中心和丹麦国家患者登记处查询情况的回顾性队列研究。这些数据库用于识别在2013年1月1日至2017年12月31日的12个月期间内有超过五次个人中毒事件的患者。
丹麦毒物信息中心和丹麦国家患者登记处分别有137名和995名患者符合纳入标准。大多数为女性（丹麦毒物信息中心队列和丹麦国家患者登记处队列分别为82.5%和66.3%）。平均年龄分别为24.7岁和29.5岁。精神疾病合并症很常见，丹麦毒物信息中心队列和丹麦国家患者登记处队列中分别有74.5%和67.0%患有个性障碍，70.1%和54.5%患有情感障碍。在丹麦毒物信息中心数据库中识别出1752次中毒事件，最常见的物质类型是“药品”（1420次事件）。摄入最多的药物是喹硫平、对乙酰氨基酚和赛克利嗪。与丹麦毒物信息中心联系的中位数次数为10次。有一次或多次涉及赛克利嗪中毒事件的患者平均有11.4次涉及赛克利嗪的中毒事件。在丹麦国家患者登记处队列中，10年后80.9%的患者存活，而背景人群中这一比例为97.7%。
大多数中毒是故意的，且发生在年轻女性中。精神疾病合并症很常见。最常见的有毒物质是药品，主要是喹硫平、对乙酰氨基酚和赛克利嗪。将赛克利嗪从非处方药改为仅凭处方用药，并对喹硫平的处方实施更严格的规定，可能会限制未来的中毒发生率。
