title: Medication Overdoses at a Public Emergency Department in Santiago, Chile.
abstract: BACKGROUND
  While a nationwide poison control registry exists in Chile, reporting to the center is sporadic and happens at the discretion of the treating physician or by patients' self-report. Moreover, individual hospitals do not monitor accidental or intentional poisoning in a systematic manner. The goal of this study was to identify all cases of intentional medication overdose (MO) that occurred over two years at a large public hospital in Santiago, Chile, and examine its epidemiologic profile.
  
  
  METHODS
  This study is a retrospective, explicit chart review conducted at Hospital Sótero del Rio from July 2008 until June 2010. We included all cases of identified intentional MO. Alcohol and recreational drugs were included only when they were ingested with other medications.
  
  
  RESULTS
  We identified 1,557 cases of intentional MO and analyzed a total of 1,197 cases, corresponding to 0.51% of all emergency department (ED) presentations between July 2008 and June 2010. The median patient age was 25 years. The majority was female (67.6%). Two peaks were identified, corresponding to the spring of each year sampled. The rate of hospital admission was 22.2%. Benzodiazepines, selective serotonin reuptake inhibitors, and tricyclic antidepressants (TCA) were the causative agents most commonly found, comprising 1,044 (87.2%) of all analyzed cases. Acetaminophen was involved in 81 (6.8%) cases. More than one active substance was involved in 35% of cases. In 7.3% there was ethanol co-ingestion and in 1.0% co-ingestion of some other recreational drug (primarily cocaine). Of 1,557 cases, six (0.39%) patients died. TCA were involved in two of these deaths.
  
  
  CONCLUSIONS
  Similar to other developed and developing nations, intentional MO accounts for a significant number of ED presentations in Chile. Chile is unique in the region, however, in that its spectrum of intentional overdoses includes an excess burden of tricyclic antidepressant and benzodiazepine overdoses, a relatively low rate of alcohol and recreational drug co-ingestion, and a relatively low rate of acetaminophen ingestion.
authors.affiliation: Facultad de Medicina, Pontificia Universidad Católica de Chile, Programa de Medicina de Urgencia, Santiago, Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Aguilera
authors.affiliation: Facultad de Medicina, Pontificia Universidad Católica de Chile, Programa de Medicina de Urgencia, Santiago, Chile.
authors.forename: Marcela
authors.initials: M
authors.lastname: Garrido
authors.affiliation: University of Southern California, Los Angeles, Department of Emergency Medicine, Los Angeles, California.
authors.forename: Eli
authors.initials: E
authors.lastname: Lessard
authors.affiliation: University of Southern California, Los Angeles, Department of Emergency Medicine, Los Angeles, California.
authors.forename: Julian
authors.initials: J
authors.lastname: Swanson
authors.affiliation: University of Southern California, Los Angeles, Department of Emergency Medicine, Los Angeles, California.
authors.forename: William K
authors.initials: WK
authors.lastname: Mallon
authors.affiliation: Facultad de Medicina, Pontificia Universidad Católica de Chile, Programa de Medicina de Urgencia, Santiago, Chile.
authors.forename: Fernando
authors.initials: F
authors.lastname: Saldias
authors.affiliation: Facultad de Medicina, Pontificia Universidad Católica de Chile, Programa de Medicina de Urgencia, Santiago, Chile.
authors.forename: Carlos
authors.initials: C
authors.lastname: Basaure
authors.affiliation: Facultad de Medicina, Pontificia Universidad Católica de Chile, Programa de Medicina de Urgencia, Santiago, Chile.
authors.forename: Barbara
authors.initials: B
authors.lastname: Lara
authors.affiliation: University of Southern California, Los Angeles, Department of Emergency Medicine, Los Angeles, California.
authors.forename: Stuart P
authors.initials: SP
authors.lastname: Swadron
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D000553:Ambulatory Care; D018712:Analgesics, Non-Narcotic / Q000506:poisoning*; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D002677:Chile / Q000453:epidemiology; D062787:Drug Overdose / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
chemical_list: D018712:Analgesics, Non-Narcotic; D000929:Antidepressive Agents, Tricyclic; D000082:Acetaminophen
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