Detailed analyses of self‐poisoning episodes presenting to a large regional teaching hospital in the UK

• Published in: British journal of clinical pharmacology Vol. 68; no. 2; pp. 260 - 268
• Main Authors: Prescott, Katherine, Stratton, Richard, Freyer, Anette, Hall, Ian, Le Jeune, Ivan
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.08.2009; Blackwell; Blackwell Science Inc
• Subjects: Acetaminophen - poisoning; Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Drug Overdose - economics; Drug Overdose - epidemiology; Drug Safety; Emergency Service, Hospital - economics; epidemiology; Female; Humans; Male; Medical sciences; Middle Aged; overdose; paracetamol; Pharmacology. Drug treatments; Retrospective Studies; Risk Factors; Self-Injurious Behavior - economics; Self-Injurious Behavior - epidemiology; self‐poisoning; United Kingdom - epidemiology; Young Adult; United Kingdom; Europe; Human; overdose; Teaching hospital; self-poisoning; Antimigrainous agent; Overdosing; Regional; Epidemiology; Paracetamol; Analgesic; Antipyretic; Poisoning; Hospital; Public health
• ISSN: 0306-5251; 1365-2125; 1365-2125
• DOI: 10.1111/j.1365-2125.2009.03458.x

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Deliberate self‐poisoning accounts for 170 000 presentations to UK hospitals each year with a profound impact on the health of individual patients. We have basic demographic information on self‐poisoning but there is a relative paucity of contemporary, detailed information on the patterns of presentation, drugs taken in overdose and the current impact on services. WHAT THIS STUDY ADDS • This study provides detailed analyses of demographics, timing of presentation, patterns of overdose, drugs taken with special emphasis on paracetamol, the patient pathway through hospital and an estimation of the financial impact to the hospital of this patient group. This information is essential in planning the necessary service developments in emergency departments and medical admissions units that are required to optimize management of this patient group. AIMS The primary aim of this paper is to provide comprehensive contemporaneous data on the demographics, patterns of presentation and management of all episodes of deliberate self‐poisoning presenting to a large regional teaching hospital over a 12 month period. METHODS We undertook detailed, retrospective analyses using information from electronic patient records and local patient‐tracking, pathology and administrative databases. Statistical analyses were performed using Chi‐squared tests, anova and two‐tailed t‐tests (Graphpad Prism). RESULTS One thousand five hundred and ninety‐eight episodes of deliberate self‐poisoning presented over the year. Demographic data and information on the month, day and time of admission are provided. 70.7% presented to the emergency department (ED) within 4 h of ingestion. 76.3% of patients had only one episode in an extended 29 month follow‐up period. A mean of 1.72 drugs were taken per episode with just over half of all episodes involving a single drug only. Paracetamol and ibuprofen were the two most commonly ingested drugs involved in 42.5% and 17.3% of all overdoses respectively. 56.3% of patients taking paracetamol reported ingesting over 8 g (one over the counter packet). Detailed mapping of the patients' pathway through the hospital allowed an estimation of the hospital cost of caring for this patient group at £1.6 million pounds per year. CONCLUSIONS We present comprehensive and contemporary data on presentations to hospital resulting from deliberate self‐poisoning. We include demographic information, presentation patterns, drugs used, a detailed analysis of episodes involving paracetamol and an estimate of the financial burden to hospitals of overdose presentations.