Patients presenting with acute poisoning to an outpatient emergency clinic: a one-year observational study in Oslo, Norway.
BACKGROUND
In Oslo, the majority of patients with acute poisoning are treated in primary care, at an emergency outpatient clinic with limited diagnostic and treatment resources. We describe the poisonings currently seen in this setting. We compare our findings with previous studies, with special concern for the appearance of new toxic agents, and changes in overall numbers and patterns of poisoning.


METHODS
Observational study. Patients above the age of 12 years presenting at Oslo Accident and Emergency Outpatient Clinic (Oslo Legevakt) with acute poisoning were included consecutively from October 2011 through September 2012. Physicians and nurses registered data on preset forms. Main outcome measures were toxic agents, age, sex, intention, referral and time of presentation.


RESULTS
There were 2923 episodes of acute poisoning in 2261 patients. Median age of the patients was 32 years, and 1430 (63%) were males. The most frequent toxic agents were ethanol in 1684 (58%) episodes, heroin in 542 (19 %), benzodiazepines in 521 (18%), amphetamine in 275 (9%), fire smoke in 192 (7%), gamma-hydroxybutyrate (GHB) in 144 (5%), and cannabis in 143 (5%). In 904 (31%) poisonings there were more than one toxic agent. In 493 episodes (17%), the patient was hospitalised, and in 60 episodes (2%) admitted to a psychiatric ward. Most poisonings, 2328 (80%), were accidental overdoses with substances of abuse, 276 (9%) were suicide attempts, and 312 (11%) were accidents. Among ethanol poisonings in patients above the age of 26 years, 685/934 (73%) were in males, and 339/934 (36%) presented during weekends. However, among ethanol poisonings in patients under the age of 26 years, 221/451 (49 ) were in females, and 297/451 (66%) presented during weekends.


CONCLUSIONS
The poisonings treated in this primary care setting were mostly due to accidental overdoses with ethanol or other substances of abuse. There is a disconcerting weekend drinking pattern among adolescents and young adults, with young females presenting as often as young males with ethanol poisoning.
Department of General Practice, University of Oslo, Oslo, Norway. o.m.vallersnes@medisin.uio.no.|Oslo Accident and Emergency Outpatient Clinic, Department of Emergency General Practice, City of Oslo Health Agency, Oslo, Norway. o.m.vallersnes@medisin.uio.no.
Odd Martin
OM
Vallersnes
Department of Acute Medicine, Oslo University Hospital, Oslo, Norway. uxdaja@ous-hf.no.
Dag
D
Jacobsen
Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. uxoiek@ous-hf.no.|Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway. uxoiek@ous-hf.no.
Øivind
Ø
Ekeberg
Department of General Practice, University of Oslo, Oslo, Norway. mette.brekke@medisin.uio.no.
Mette
M
Brekke
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D002648:Child; D003430:Cross-Sectional Studies; D062787:Drug Overdose / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011041:Poisoning / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D011320:Primary Health Care / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D055815:Young Adult