Outcomes and Costs of Poisoned Patients Admitted to an Adult Emergency Department of a Spanish Tertiary Hospital: Evaluation through a Toxicovigilance Program.
Toxicovigilance is the active process of identifying and evaluating the toxic risks existing in a community, and evaluating the measures taken to reduce or eliminate them.


OBJECTIVE
Through a validated toxicovigilance program (SAT-HULP) we examined the characteristics of acute poisoning cases (APC) attended in the Emergency Department (ED) of La Paz Hospital (Madrid, Spain) and assessed their economic impact on the health system.


METHODS
The active poisoning surveillance system performs a daily search for cases in the hospital´s computerized case records. Found cases are entered into a database for recording of type of poisoning episode, reasons for exposure, causative agent, signs and symptoms and treatment. We carried out a cross-sectional epidemiological study with analytical projection, based on an impact study on cost per survivor. The data for the costs attributable to cases of APC observed at HULP (outpatients and inpatients) was obtained from the based on the information provided by the diagnosis-related groups (DRG) through the corresponding hospital discharge reports (available through SAT-HULP).


RESULTS
During the first 30 month of SAT-HULP operation we found a total of 3,195 APC, a cumulative incidence rate of 1.75% of patients attended in the ED. The mean (SD) patient age was 40.9 (17.8) years and 51.2% were men. Drug abuse accounted for 47.5% of the cases. Suicide attempt was the second most frequent category (38.1%) and other causes accounted for 14.5% of APC. The total cost of hospital care for our hospital rose to €1,825,263.24 (approximately €730,105.30/year) resulting in a permanent occupation of 4 beds/year.


CONCLUSIONS
SAT-HULP constitutes a validated toxicovigilance tool, which continuously integrates available data in real-time and helps health services manage APC data flexibly, including the consumption of resources from the health system.
Clinical Pharmacology Deparment, Hospital Universitario La Paz, IdiPaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.|Clinical Toxicology Unit, Hospital Universitario La Paz, Madrid, Spain.
Raúl
http://orcid.org/0000-0002-7071-6421
R
Muñoz
Clinical Pharmacology Deparment, Hospital Universitario La Paz, IdiPaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.|Accident and Emergency Department, Critical Care Department, Hospital Universitario La Paz, School of Medicine, IdiPaz, Universidad Autónoma de Madrid, Madrid, Spain.|Clinical Toxicology Unit, Hospital Universitario La Paz, Madrid, Spain.
Alberto M
AM
Borobia
Accident and Emergency Department, Critical Care Department, Hospital Universitario La Paz, School of Medicine, IdiPaz, Universidad Autónoma de Madrid, Madrid, Spain.|Clinical Toxicology Unit, Hospital Universitario La Paz, Madrid, Spain.
Manuel
M
Quintana
Accident and Emergency Department, Critical Care Department, Hospital Universitario La Paz, School of Medicine, IdiPaz, Universidad Autónoma de Madrid, Madrid, Spain.|Clinical Toxicology Unit, Hospital Universitario La Paz, Madrid, Spain.
Ana
A
Martínez
Clinical Pharmacology Deparment, Hospital Universitario La Paz, IdiPaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
Elena
E
Ramírez
Clinical Pharmacology Deparment, Hospital Universitario La Paz, IdiPaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.|Clinical Toxicology Unit, Hospital Universitario La Paz, Madrid, Spain.
Mario
M
Muñoz
Clinical Pharmacology Deparment, Hospital Universitario La Paz, IdiPaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.|Clinical Toxicology Unit, Hospital Universitario La Paz, Madrid, Spain.
Jesús
J
Frías
Clinical Pharmacology Deparment, Hospital Universitario La Paz, IdiPaz, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.|Clinical Toxicology Unit, Hospital Universitario La Paz, Madrid, Spain.
Antonio J
AJ
Carcas
D000328:Adult; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups / Q000191:economics; D004636:Emergency Service, Hospital / Q000191:economics*; D005260:Female; D006295:Health Resources / Q000191:economics; D006296:Health Services / Q000191:economics*; D006630:Hispanic or Latino; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D013030:Spain; D017741:Survivors; D062606:Tertiary Care Centers / Q000191:economics*