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Elderly patients visiting the emergency department for deliberate self-poisoning: do they present a more severe poisoning severity score than the nonelderly patients in the initial 24 h?

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Abstract

Purpose

Many elderly patients arrive at the emergency department (ED) complaining of deliberate self-poisoning (DSP). This study determined the poisoning severity of elderly patients who committed DSP.

Methods

A study was performed with 1329 patients (> 15 years of age) who were treated for DSP at two EDs between January 2010 and December 2016. We classified these patients into two groups based on age (an elderly group ≥ 65 years of age and a nonelderly group). Information was collected on age, sex, cause, ingestion time, drug type, suicide attempt history, initial poisoning severity score (PSS), final PSS, outcome, etc.

Results

In total, 242 (18.2%) patients were included in the elderly group, of whom 211 (86.9%) were treated for a first suicide attempt. Admission to the intensive-care unit (ICU) (43.8% vs. 25.5%) and endotracheal intubation (16.1% vs. 4.9%) occurred more frequently in the elderly group than in the nonelderly group (p < 0.001). The frequencies of initial severe PSSs (3 and 4) in the elderly group were 9.1% (N = 22) and 1.2% (N = 3), respectively. Multivariate logistic regression analysis showed that the ICU admission of DSP patients was significantly associated with being elderly (OR of 1.47, 95% CI 1.04–2.09, p = 0.029) and with having a GCS of < 13 (OR of 2.67, 95% CI 1.99–3.57, p < 0.001) and an initial PSS of (3,4) (OR of 3.66, 95% CI 2.14–6.26, p < 0.001). In addition, the presence of underlying diseases (coronary heart disease and cerebrovascular disease) yielded high ORs [(OR of 13.13, 95% CI 2.80–61.57, p = 0.001), (OR of 7.34, 95% CI 1.38–39.09, p = 0.020)].

Conclusion

Elderly patients who visited the ED for DSP exhibited overall more severe PSSs and poorer in-hospital prognosis than did nonelderly DSP patients.

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Abbreviations

ED:

Emergency department

DSP:

Deliberate self-poisoning

PSS:

Poisoning severity score

ICU:

Intensive-care unit

GCS:

Glasgow coma scale

MDD:

Major depressive disorder

DBP:

Diastolic blood pressure

PR:

Pulse rate

RR:

Respiratory rate

SBP:

Systolic blood pressure

EMS:

Emergency medical services

IQR:

Interquartile range

ORs:

Odds ratios

CI:

Confidence interval

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Acknowledgements

The authors wish to acknowledge the financial support of the Catholic Medical Center Research Foundation during the program year of 2018.

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Authors and Affiliations

  1. Department of Emergency Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Sungyoup Hong

  2. Department of Emergency Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, #56 Dongsu-ro, Bupyeong-gu, Incheon, Seoul, Republic of Korea

    Woon Jeong Lee, Dae Hee Kim, Seung Hwan Seol, June Young Lee, Sang Kook In, Hye Won Lee & Seon Hee Woo

  3. Department of Emergency Medicine, Yeouido St. Mary’s hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Jung Hee Wee

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  1. Sungyoup Hong
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Contributions

SH, JHW, and WJL performed data analysis and drafted the manuscript. DHK, SHW, and HWL acquired data and critically revised the manuscript. SKI, JYL, and SHS managed the data and revisions to the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Seon Hee Woo.

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Conflict of interest

The authors do not have any financial or other relationships that might pose any conflicts of interest.

Statement of human and animal rights

All procedures performed in studies involving patients were in accordance with the ethical standards of the institution and/or national research. The protocol was approved by the Institutional Review Board of Incheon St. Mary’s Hospital.

Informed consent

Because the clinical measurements were part of routine patient management in the emergency department, informed consent was unnecessary, which was confirmed by the Institutional Review Board.

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Hong, S., Lee, W.J., Kim, D.H. et al. Elderly patients visiting the emergency department for deliberate self-poisoning: do they present a more severe poisoning severity score than the nonelderly patients in the initial 24 h?. Aging Clin Exp Res 31, 1139–1146 (2019). https://doi.org/10.1007/s40520-018-1053-3

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  • DOI: https://doi.org/10.1007/s40520-018-1053-3

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