TY  - JOUR
PY  - 2017//
TI  - Self-poisoning by older Australians: a cohort study
JO  - Medical journal of Australia
A1  - Pillans, Peter I.
A1  - Page, Colin B.
A1  - Ilango, Sivarajah
A1  - Kashchuk, Anna
A1  - Isbister, Geoffrey K.
SP  - 164
EP  - 169
VL  - 206
IS  - 4
N2  - 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. DESIGN, SETTING, PARTICIPANTS: A cohort study of people presenting to a tertiary toxicology centre after self-poisoning over 26 years (1987-2012). MAIN OUTCOME MEASURES: Hospital length of stay (LOS); types of drug ingested; intensive care unit (ICU) admissions; in-hospital deaths. <br><br>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. <br><br>CONCLUSION: 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.<p />  <p>Language: en</p>
LA  - en
SN  - 0025-729X
UR  - http://dx.doi.org/
ID  - ref1
ER  -