title: Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003-2011.
abstract: In recent years, there has been an increase in poisoning-related emergency department (ED) visits. This study examines trends in ED resource utilization for poisoning-related visits over time. A retrospective review of data from the National Hospital Ambulatory Medical Care Survey, 2003-2011, was conducted. All ED visits with a reason for visit or ICD-9 code related to poisoning were included. We examined the number of ED visits and resources used including diagnostic studies and procedures performed, medications provided, admission rates, and length of stay. The proportion of visits involving resource use was tabulated and trends analyzed using survey-weighted logistic regression, grouping into 2-year periods to ensure adequate sample size. Of an estimated 843 million ED visits between 2003 and 2011, 8 million (0.9 %) were related to poisoning. Visits increased from 1.8 million (0.8 %) visits in 2003-2004 to 2.9 million (1.1 %) visits in 2010-2011, p = 0.001. Use of laboratory studies, EKGs, plain radiographs, and procedures remained stable across the study period. CT use was more than doubled, increasing from 5.2 to 13.7 % of visits, p = 0.001. ED length of stay increased by 35.5 % from 254 to 344 min, p = 0.001. Admission rates increased by 45.3 %, from 15.0 to 21.8 %, p = 0.046. Over the entire study period, 52.0 % of poisoned patients arrived via ambulance, and 3.0 % of patients had been discharged from the hospital within the previous 7 days. Poisoning-related ED visits increased over the 8-year study period; poisonings are resource-intensive visits and require increasingly longer lengths of ED stay or hospital admission.
authors.affiliation: Department of Emergency Medicine, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC, 20010, USA. maryannmazer@gmail.com.|Georgetown University School of Medicine, Washington, DC, USA. maryannmazer@gmail.com.
authors.forename: Maryann
authors.initials: M
authors.lastname: Mazer-Amirshahi
authors.affiliation: Department of Emergency Medicine, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC, 20010, USA.
authors.forename: Christie
authors.initials: C
authors.lastname: Sun
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Mullins
authors.affiliation: Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
authors.forename: Jeanmarie
authors.initials: J
authors.lastname: Perrone
authors.affiliation: Department of Emergency Medicine, New York University, New York, NY, USA.
authors.forename: Lewis
authors.initials: L
authors.lastname: Nelson
authors.affiliation: Department of Emergency Medicine, George Washington University, Washington, DC, USA.|Center for Clinical Practice Innovation, George Washington University, Washington, DC, USA.
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Pines
mesh_terms: D000293:Adolescent; D000328:Adult; D000552:Ambulances / Q000191:economics; D000931:Antidotes / Q000191:economics / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy / Q000191:economics / Q000639:trends; D062787:Drug Overdose / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D004636:Emergency Service, Hospital / Q000191:economics / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D019456:Health Transition; D017721:Hospital Costs / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000639:trends; D008297:Male; D011041:Poisoning / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000639:trends; D040841:Resource Allocation / Q000191:economics / Q000639:trends; D012189:Retrospective Studies; D014481:United States
chemical_list: D000931:Antidotes
keywords: Emergency department; Poisoning; Resource utilization