title: The Toxicology Investigators Consortium Case Registry-the 2015 Experience.
abstract: The American College of Medical Toxicology established the Toxicology Investigators Consortium (ToxIC) Case Registry in 2010. The Registry contains all medical toxicology consultations performed at participating sites. The Registry has continued to grow since its inception, and as of December 31, 2015, contains 43,099 cases. This is the sixth annual report of the ToxIC Registry, summarizing the additional 8115 cases entered in 2015. Cases were identified by a query of the Registry for all cases entered between January 1 and December 31, 2015. Specific data reviewed for analysis included demographics (age, race, gender), source of consultation, reason for consultation, agents and agent classes involved in exposures, signs, symptoms, clinical findings, fatalities, and treatment. By the end of 2015, there were 50 active sites, consisting of 101 separate health-care facilities; 51.2 % of cases involved females. Adults between the ages of 19 and 65 made up the majority (64.2 %) of Registry cases. Caucasian race was the most commonly reported (55.6 %); 9.6 % of cases were identified as Hispanic ethnicity. Inpatient and emergency department referrals were by far the most common referral sources (92.9 %). Intentional pharmaceutical exposures remained the most frequent reason for consultation, making up 52.3 % of cases. Of these intentional pharmaceutical exposures, 69 % represented an attempt at self-harm, and 85.6 % of these were a suicide attempt. Nonopioid analgesics, sedative-hypnotics, and antidepressant agents were the most commonly reported agent classes in 2015. Almost one-third of Registry cases involved a diagnosed toxidrome (32.8 %), with a sedative-hypnotic toxidrome being the most frequently described. Significant vital sign abnormalities were recorded in 25.3 % of cases. There were 98 fatalities reported in the Registry (1.2 %). Adverse drug reactions were reported in 4.3 % of cases. Toxicological treatment was given in 65.3 % of cases, with 33.0 % receiving specific antidotal therapy. Exposure characteristics and trends overall were similar to prior years. While treatment interventions were required in the majority of cases, fatalities were rare.
authors: Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA. Lynn.Farrugia@hhchealth.org.
authors: Lynn A
authors: LA
authors: Farrugia
authors: Saint Francis Hospital and Medical Center, 114 Woodland St., Hartford, CT, 06105, USA.
authors: Sean H
authors: SH
authors: Rhyee
authors: American College of Medical Toxicology, 10645 N. Tatum Blvd., Suite 200-111, Phoenix, AZ, 85028, USA.
authors: Sharan L
authors: SL
authors: Campleman
authors: Banner-University Medical Center Phoenix, 925 E. McDowell Rd, Phoenix, AZ, 85006, USA.
authors: Anne-Michelle
authors: AM
authors: Ruha
authors: University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA.
authors: Timothy
authors: T
authors: Weigand
authors: UT Southwestern Medical School, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA.
authors: Paul M
authors: PM
authors: Wax
authors: University of Colorado School of Medicine, 13001 E 17th Pl., Aurora, CO, 80045, USA.
authors: Jeffrey
authors: J
authors: Brent
mesh_terms: D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000737:chemistry / Q000506:poisoning*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000737:chemistry / Q000506:poisoning*; D000931:Antidotes / Q000627:therapeutic use; D002648:Child; D062787:Drug Overdose / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000037:antagonists & inhibitors / Q000506:poisoning*; D007223:Infant; D011041:Poisoning / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D012017:Referral and Consultation; D012042:Registries; D012108:Research Personnel; D018571:Sentinel Surveillance; D012958:Societies, Scientific; D013406:Suicide, Attempted; D014116:Toxicology; D014117:Toxiferine / Q000009:adverse effects / Q000037:antagonists & inhibitors / Q000506:poisoning; D014481:United States; D000078329:Workforce
chemical_list: D018712:Analgesics, Non-Narcotic; D000928:Antidepressive Agents; D000931:Antidotes; D006993:Hypnotics and Sedatives; D014117:Toxiferine
keywords: Epidemiology; Medical toxicology; Overdose; Poisonings; Surveillance