Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Australia.
School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, University of New South Wales Sydney, Australia.
Clin Toxicol (Phila). 2024 Oct;62(10):625-635. doi: 10.1080/15563650.2024.2398766. Epub 2024 Sep 18.
Poisons information centres provide phone-based risk assessment and management advice on poisonings. Unintentional poisonings are a common reason for consulting a poisons information centre, and older adults are at increased risk of unintentional poisoning and adverse outcomes. We describe patterns of unintentional poisoning in older adults reported to a regional poisons information centre.
We conducted a retrospective audit of poisons information centre call records and identified unintentional poisonings involving older adults (≥75 years) over a 12-month period to determine patient demographics and poisoning circumstances (substances, contributing factors, and disposition recommendation). Univariate analyses identified variables associated with hospital referral and multivariate models to identify independent risk factors in home-dwelling older adults.
We identified 2,757 calls. More exposures occurred in women (62%) and involved therapeutic errors (70.8%). Paracetamol was the most common drug involved (11%), and cardiovascular drugs were the most common drug class (36%). Only 14.3% of the study population was referred to hospital. Independent risk factors for hospital referral in home-dwelling older adults were exposure to cardiovascular, centrally acting and antihyperglycaemics, non-oral route of administration and symptoms at the time of the call.
Unintentional poisoning is not uncommon, and our findings are similar to those in other countries over recent decades. These findings suggest that unintentional poisoning in older adults is inadequately addressed by current medication safety strategies. Our findings indicate the value of timely advice by poisons information centres for preventing potentially unnecessary hospitalizations.
Further research is needed to identify more effective approaches to medication safety strategies for older adults. Poisons information centre data contribute to pharmacovigilance activities and could inform patient care.
中毒信息中心提供基于电话的中毒风险评估和管理建议。非故意中毒是咨询中毒信息中心的常见原因，老年人发生非故意中毒和不良后果的风险增加。我们描述了向区域中毒信息中心报告的老年人非故意中毒的模式。
我们对中毒信息中心的电话记录进行了回顾性审计，并确定了在 12 个月期间涉及老年人（≥75 岁）的非故意中毒，以确定患者的人口统计学特征和中毒情况（物质、促成因素和处置建议）。单变量分析确定了与医院转介相关的变量，多变量模型确定了居家老年人中独立的危险因素。
我们确定了 2757 个电话。女性（62%）发生的暴露更多，涉及治疗错误（70.8%）。对乙酰氨基酚是最常见的药物（11%），心血管药物是最常见的药物类别（36%）。只有 14.3%的研究人群被转介到医院。居家老年人住院的独立危险因素是接触心血管、中枢作用和抗高血糖药物、非口服给药途径和来电时出现症状。
非故意中毒并不少见，我们的发现与最近几十年其他国家的发现相似。这些发现表明，当前的药物安全策略未能充分解决老年人的非故意中毒问题。我们的发现表明，中毒信息中心提供及时建议对于预防潜在的不必要住院非常有价值。
需要进一步研究以确定针对老年人的更有效的药物安全策略方法。中毒信息中心的数据有助于药物警戒活动，并能为患者护理提供信息。
