Department of Global Public Health , Karolinska Institutet, Widerströmska huset Tomtebodavägen 18A, 17177, Stockholm, Sweden.
BMC Geriatr. 2024 Feb 15;24(1):157. doi: 10.1186/s12877-024-04717-8.
Poisoning injuries is an increasing concern among older people, and so is the repetition of intentional poisonings. To date, few studies have documented the pattern and individual risk factors for repeated poisonings. This national study aims to shed light on the burden, pattern, and health-related risk factors of repeated intentional poisoning leading to hospitalization or death among older Swedish adults (50 years and older), with a focus on the year following a first event.
We conducted a nationwide register-based cohort study of people aged 50-100, hospitalized for intentional poisoning (ICD10: X60-69) during 2006-2016 (n = 15,219) and re-hospitalized by poisoning of any intent within a year (n = 1710), i.e., up to the end of 2017. We considered in turn, the distribution of the second poisoning in 30-day intervals stratified by intent; poisoning lethality within a month and a year; and the sex-specific association between health conditions and being re-hospitalized for intentional poisoning within one year as compared to being hospitalized only once using logistic regression (odds ratios (OR) with 95% confidence intervals (95% CI)).
Following an intentional poisoning, re-hospitalization within a year was predominantly for a new intentional poisoning (89.7%) and occurred most typically within a month (median 4 days). Death within 30 days occurred in similar proportion for the first and second poisoning (2.3% vs. 2.1% respectively). Among both men and women, comorbidity of psychiatric illness was strongly associated with re-hospitalization for intentional poisoning (adjusted ORs = 1.70; 95% CI = 1.45-2.01 and 1.89 (95% CI = 1.60-2.19) respectively).
Most re-hospitalizations within a year after intentional poisoning are also for intentional poisoning and occur most typically within days. Re-hospitalization is associated with several conditions that are characteristic of poor mental health and there are more similarities than differences between men and women in that respect.
中毒伤害是老年人日益关注的问题，故意重复中毒的情况也在增加。迄今为止，很少有研究记录重复中毒的模式和个体危险因素。本项全国性研究旨在阐明瑞典 50 岁以上老年人（50-100 岁）因重复故意中毒导致住院或死亡的负担、模式和与健康相关的危险因素，重点关注首次事件发生后的一年。
我们对 2006 年至 2016 年期间因故意中毒（ICD10：X60-69）住院的年龄在 50-100 岁的人群进行了一项全国性基于登记的队列研究（n=15219），并对一年内因任何意图再次中毒而重新住院的人群（n=1710）进行了研究，即截至 2017 年底。我们依次考虑了第二次中毒在 30 天间隔内按意图的分布；一个月和一年内的中毒致死率；以及使用逻辑回归（优势比（OR）及其 95%置信区间（95%CI））比较性别特异性健康状况与一年内因故意中毒再次住院与仅住院一次之间的关联。
在一次故意中毒后，一年内再次住院主要是因为新的故意中毒（89.7%），并且最典型的发生在一个月内（中位数 4 天）。在 30 天内死亡的情况，首次和第二次中毒的比例相似（分别为 2.3%和 2.1%）。在男性和女性中，精神疾病合并症与因故意中毒而再次住院密切相关（调整后的 OR 分别为 1.70（95%CI 为 1.45-2.01）和 1.89（95%CI 为 1.60-2.19））。
在故意中毒后一年内再次住院的大多数情况也是故意中毒，并且最典型的发生在几天内。再次住院与多种状况相关，这些状况是心理健康状况不佳的特征，并且在这方面，男性和女性之间的相似之处多于差异。
