Lirón-García Álvaro, Ramos-Rincón José-Manuel, Valero-Novella Beatriz, Marín-Aparicio Juan, Sánchez-Martínez Rosario, Llorens Pere
Servicio de Urgencias, Hospital Universitario Reina Sofía, Murcia, Spain.
Servicio de Medicina Interna, Hospital General Universitario Dr. Balmis, Alicante, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain; Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Alicante, Spain.
Rev Clin Esp (Barc). 2023 Oct 27. doi: 10.1016/j.rceng.2023.10.006.
The objective of this study was to examine the epidemiology of acute poisonings in the emergency department (ED) of a tertiary center and to analyze the compliance level with quality indicators (QIs) in patients 65 years and older compared rest of adults.
This was an observational and retrospective study that included diagnosed cases of acute poisoning in patients over 14 years old treated in the ED of a tertiary hospital. Demographic variables, type of toxic substances, and cause of poisoning were collected, along with 19 QIs and patient outcomes, with the main outcome variable being the degree of compliance with the QIs.
A total of 1,144 cases were recorded, with 10.4% (n = 119) being patients 65 years and older. Patients 65 years and older were more likely to be female (72.8% vs. 60.9%; p = 0.015), experience more accidental poisonings (37.6% vs. 25.7%; p = 0.006), and fewer intentional poisonings (35.0% vs. 49.6%; p = 0.003). There were fewer cases of alcohol poisoning (5% vs. 17.8%; <0.001), and no cases of illegal drug poisoning (p < 0.001) in this age group. Most QIs showed a high degree of compliance (>85%) in both patients 65 years and older and rest of adults. However, there were differences in the indication of oxygen therapy in cases of carbon monoxide poisoning (64.2% vs. 40.9%; p = 0.005).
The epidemiological profile of poisoning in patients 65 years and older differs from that of adult patients, with a similar degree of compliance with QIs. Based on the results obtained, there does not appear to be significant differences in the management of poisoned patients based on their age.
本研究的目的是调查一家三级中心急诊科急性中毒的流行病学情况，并分析65岁及以上患者与其他成年人相比对质量指标（QIs）的依从程度。
这是一项观察性回顾性研究，纳入了在一家三级医院急诊科接受治疗的14岁以上急性中毒确诊病例。收集了人口统计学变量、有毒物质类型和中毒原因，以及19项质量指标和患者结局，主要结局变量是对质量指标的依从程度。
共记录了1144例病例，其中65岁及以上患者占10.4%（n = 119）。65岁及以上患者女性比例更高（72.8%对60.9%；p = 0.015），意外中毒更多（37.6%对25.7%；p = 0.006），故意中毒更少（35.0%对49.6%；p = 0.003）。该年龄组酒精中毒病例较少（5%对17.8%；<0.001），且无非法药物中毒病例（p < 0.001）。大多数质量指标在65岁及以上患者和其他成年人中均显示出较高的依从性（>85%）。然而，一氧化碳中毒病例中氧疗指征存在差异（64.2%对40.9%；p = 0.005）。
65岁及以上中毒患者的流行病学特征与成年患者不同，但对质量指标的依从程度相似。根据所得结果，基于年龄对中毒患者进行管理似乎没有显著差异。
