Linakis J G, Frederick K A
Department of Pediatrics, Brown University, Providence.
Ann Emerg Med. 1993 Dec;22(12):1822-8. doi: 10.1016/s0196-0644(05)80408-1.
This study was designed to characterize poisoning deaths in Rhode Island and to determine the incidence of poisoning deaths that are not reported to the regional poison center.
The records of the state medical examiner were reviewed retrospectively for all toxin-related deaths from January 1986 through December 1989, and those deaths were compared with deaths recorded by the poison center during the same period.
All patients whose deaths were due to a toxic substance and were recorded by either the state medical examiner's office or the regional poison center during the four-year study period.
Age, sex, location of death, cause of death (both primary and secondary toxins were noted), manner of death (accidental, suicide, undetermined), and the circumstances surrounding the death were recorded for each victim. Medical examiner and poison center cases were matched and compared using a computerized data base program.
During the study period, 369 deaths reported to the medical examiner were attributed to poisoning, while 45 poisoning deaths were recorded by the poison center. Of the deaths reported to the medical examiner, the most common reasons for lack of reporting to the poison center were that death occurred at a residence or patients were dead on arrival at the hospital and a toxin was not suspected until an autopsy was performed. Seventy-nine other poisoning victims arrived at the hospital alive with a suspected toxic exposure and hypothetically could have been reported to the poison center but were not.
The medical examiner's office represents a significant source of statistics regarding poisoning deaths, the majority of toxic deaths not reported to the poison center are dead on arrival, and using deaths as the dependent measure, the poison center may be underutilized in severe poisoning cases.
本研究旨在描述罗德岛州中毒死亡情况，并确定未向区域中毒控制中心报告的中毒死亡发生率。
对1986年1月至1989年12月期间州法医记录的所有与毒素相关的死亡记录进行回顾性审查，并将这些死亡情况与同期中毒控制中心记录的死亡情况进行比较。
在为期四年的研究期间，所有因有毒物质死亡且由州法医办公室或区域中毒控制中心记录的患者。
记录每位受害者的年龄、性别、死亡地点、死因（同时记录主要和次要毒素）、死亡方式（意外、自杀、不明）以及死亡相关情况。使用计算机数据库程序对法医和中毒控制中心的病例进行匹配和比较。
在研究期间，法医报告的369例死亡归因于中毒，而中毒控制中心记录了45例中毒死亡。在向法医报告的死亡中，未向中毒控制中心报告的最常见原因是死亡发生在住所，或患者到达医院时已死亡，直到尸检时才怀疑有毒素。另外79名中毒受害者在疑似有毒暴露的情况下活着到达医院，理论上本可报告给中毒控制中心，但并未报告。
法医办公室是中毒死亡统计数据的重要来源，大多数未向中毒控制中心报告的中毒死亡是到达医院时已死亡，以死亡作为相关衡量标准，中毒控制中心在严重中毒病例中可能未得到充分利用。
