Elderly patients with deliberate self-poisoning treated in an Australian general hospital.
OBJECTIVE
To examine the demographic, prescription, ingestion, and psychiatric diagnostic factors that distinguished elderly from nonelderly patients treated for deliberate self-poisoning (DSP).


METHODS
A prospective case series study of 2,667 patients presenting to a regional referral center for poisoning (Newcastle Mater Hospital, NSW, Australia), January 1991 to July 1998. The sample was stratified into two groups, 65 years or greater (n = 110) and 64 years or less (n = 2,557) at the time of index admission. The groups were compared using a forward stepwise logistic regression model. Uncontrolled comparisons were analyzed by chi-square statistic with Bonferroni-adjusted p values and controlled comparisons by odds ratio (OR) with 95% confidence interval (CI).


RESULTS
The elderly group represented 4.1% of the total. The logistic regression analysis found the elderly DSP group was more likely to have a longer length of stay (OR 5.90, CI 3.87-9.00), to have been prescribed "other" drugs (neither benzodiazepines, mood treatment drugs, nor paracetamol) before admission (OR 5.32, CI 3.34-8.48), to have been prescribed benzodiazepines (OR 3.15, CI 2.03-4.89), and to be diagnosed with major depression (OR 2.17, CI 1.41-3.36) than the younger group. The elderly group was less likely to have ingested paracetamol (OR 0.28, CI 0.14-0.54) or "other" drugs (neither benzodiazepines nor mood treatment drugs) in the DSP episode (OR 0.33, CI 0.20-0.54).


CONCLUSIONS
Elderly DSP patients differ in several important respects from younger patients. They have higher morbidity as a result of the DSP. Major depression plays a more important role. The strong relationship between benzodiazepine prescription and DSP in the elderly raises questions and possible prevention strategies.
Ticehurst
Stephen
S
Faculty of Medicine and Health Sciences, The University of Newcastle, Callaghan, Australia. mdsbt@mail.newcastle.edu.au
Carter
Gregory Leigh
GL
Clover
Kerrie Ann
KA
Whyte
Ian McGregor
IM
Raymond
Judy
J
Fryer
Jane
J
D017677:Age Distribution; D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001569:Benzodiazepines; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D062787:Drug Overdose / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D017723:Drug Utilization Review; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009517:New South Wales / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013406:Suicide, Attempted / Q000517:prevention & control / Q000706:statistics & numerical data*
D014151:Anti-Anxiety Agents; D001569:Benzodiazepines