Self-poisoning in older adults: patterns of drug ingestion and clinical outcomes.
OBJECTIVE
self-poisoning accounts for a substantial proportion of acute medical hospital presentations, but has been poorly characterised in older adults. This study sought to determine the agents ingested by older adults presenting to hospital after drug overdose, and to compare clinical outcomes to younger patients.


METHODS
a retrospective observational study of patients admitted via the emergency department due to drug overdose between 2004 and 2007.


RESULTS
during the study period, there were 8,059 admissions, including 4,632 women (57.5%). This included a subgroup of 361 patients (4.5%) who were >60 years of age. This subgroup was more likely to require hospital stay >1 night, odds ratio (95% confidence interval) = 4.3 (3.6-5.5, P < 0.0001), transfer to a critical care area = 3.8 (1.1-13.0, P = 0.0340) and had higher mortality = 4.8 (1.1-22.1, P = 0.0463). A higher proportion of older patients required transfer to a psychiatric unit (P < 0.0001) or to a general medical ward (P < 0.0001) than younger adults.


CONCLUSIONS
older adults that presented to hospital after drug overdose had ingested different drugs than younger patients, possibly due to different prescribing patterns, and had a poorer outcome. The use of drugs associated with significant toxicity should be avoided in older patients at risk of self-harm.
Doak
Martin W
MW
The Scottish Poisons Information Bureau, Royal Infirmary of Edinburgh, Scotland, UK.
Nixon
Andrew C
AC
Lupton
David J
DJ
Waring
W Stephen
WS
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D014150:Antipsychotic Agents / Q000506:poisoning*; D016001:Confidence Intervals; D062787:Drug Overdose / Q000453:epidemiology*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D055553:Prescription Drugs / Q000506:poisoning*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000929:Antidepressive Agents, Tricyclic; D014150:Antipsychotic Agents; D055553:Prescription Drugs