title: Self-poisoning by older Australians: a cohort study.
abstract: OBJECTIVE
  To examine the epidemiology and severity of self-poisoning by older people in Australia; to compare these data with those for overdoses in younger adults.
  
  
  METHODS
  A cohort study of people presenting to a tertiary toxicology centre after self-poisoning over 26 years (1987-2012).
  
  
  METHODS
  Hospital length of stay (LOS); types of drug ingested; intensive care unit (ICU) admissions; in-hospital deaths.
  
  
  RESULTS
  Of 17 276 admissions, 626 patients (3.6%) were at least 65 years old. There was a steady decline in the number of overdoses with age. Most self-poisoning by older people was intentional (80% of admissions), but the proportion of unintentional poisonings increased with age (P < 0.001). Median LOS for older patients was 34 h (interquartile range [IQR], 16-75 h), longer than for younger patients (16 h; IQR, 9-25 h; P < 0.001). 133 older patients (21.2%) were admitted to an ICU, compared with 1976 younger patients (11.9%; P < 0.001). 24 older patients (3.8%) and 93 younger patients (0.6%) died; mortality among older patients declined over time. Hypotension and arrhythmias were more common in patients over 65. Benzodiazepines (24%) were the drugs most commonly ingested by older patients, but opioids the most frequently taken drugs in fatal cases. Toxic ingestion of cardiovascular drugs increased threefold over the 26 years; about one-third of poisonings were unintentional or iatrogenic. Recreational drugs were implicated in the admissions of four older patients (0.6%), but in 7.8% of those of people under 65.
  
  
  CONCLUSIONS
  Older patients treated for self-poisoning differ in several important respects from patients under 65. They are more severely affected by self-poisoning: LOS is greater, and ICU admission and mortality rates are higher.
authors.affiliation: Princess Alexandra Hospital, Brisbane, QLD peter.pillans@health.qld.gov.au.
authors.forename: Peter I
authors.initials: PI
authors.lastname: Pillans
authors.affiliation: Princess Alexandra Hospital, Brisbane, QLD.
authors.forename: Colin B
authors.initials: CB
authors.lastname: Page
authors.affiliation: Princess Alexandra Hospital, Brisbane, QLD.
authors.forename: Sivarajah
authors.initials: S
authors.lastname: Ilango
authors.affiliation: Princess Alexandra Hospital, Brisbane, QLD.
authors.forename: Anna
authors.initials: A
authors.lastname: Kashchuk
authors.affiliation: University of Newcastle, Newcastle, NSW.
authors.forename: Geoffrey K
authors.initials: GK
authors.lastname: Isbister
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D062787:Drug Overdose / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D011041:Poisoning / Q000453:epidemiology*; D055553:Prescription Drugs / Q000506:poisoning*; D013405:Suicide / Q000706:statistics & numerical data*
chemical_list: D055553:Prescription Drugs