title: [Deaths from propofol abuse : Survey of institutes of forensic medicine in Germany, Austria and Switzerland].
abstract: Previous references suggesting a high mortality of propofol addiction in medical personnel were mostly based on surveys of the heads of medical departments or case reports; therefore, a questionnaire was sent to 48 forensic medicine departments in Germany, Austria and Switzerland concerning the number of autopsies carried out between 2002-2112 on medical personnel with the suspicion of abuse of propofol or other analgesics. The response rate was 67%. In 16 out of the 32 responding departments 39 deaths (27 males) were observed with previous connections to anesthesiology, intensive care or emergency departments of which 22 were physicians, 13 nurses, 2 other personnel and 2 were unknown. Propofol was the major cause of death in 33 cases (85%), in 8 cases including 7 with propofol, an unintentional accident was recorded and 29 were determined to be suicide. In 14 cases chronic abuse was denied but actually excluded by toxicological analysis in only 2 cases. In 11 cases involving suicide the question of abuse was not investigated. This survey confirmed previous data about the central role of propofol for the fatal outcome of addiction and suicide of anesthetists and other medical personnel. A dual prevention strategy with low-threshold offers for persons at risk and strategies for early detection is urgently needed including a stricter control of dispensing, improvement in forensic medical documentation and the use of toxicological investigations in every case of suspected abuse.
authors.affiliation: Abteilung für Schmerzmedizin, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland. christoph.maier@rub.de.
authors.forename: C
authors.initials: C
authors.lastname: Maier
authors.affiliation: Abteilung für Schmerzmedizin, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Iwunna
authors.affiliation: Institut für Rechtsmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Tsokos
authors.affiliation: Forensisch-Toxikologisches Centrum München GmbH, München, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Mußhoff
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous; D000072077:Anesthetists; D001317:Austria / Q000453:epidemiology; D002423:Cause of Death; D004282:Documentation; D005260:Female; D005858:Germany / Q000453:epidemiology; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010815:Physician Impairment; D010820:Physicians; D015742:Propofol; D019966:Substance-Related Disorders / Q000401:mortality*; D013405:Suicide / Q000706:statistics & numerical data; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol
keywords: Anesthetists; Autopsies; Drug abuse; Non-intended death; Respiratory arrest; Suicide