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Characteristics and costs in adults with acute poisoning admitted to the emergency department of a university hospital in Belgium


Autoři: Anne-Marie K. Descamps aff001;  Dominique M. Vandijck aff002;  Walter A. Buylaert aff004;  Martine A. Mostin aff001;  Peter De Paepe aff004
Působiště autorů: Antigifcentrum/Centre Antipoisons, Brussels, Belgium aff001;  Department of Public Health of Ghent University, Ghent, Belgium aff002;  Department of Medicine and Health Sciences of Hasselt University, Diepenbeek, Belgium aff003;  Department of Emergency Medicine of Ghent University Hospital, Ghent, Belgium aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223479

Souhrn

Objective

The aims of this study were to assess the characteristics of all acute poisoning admissions among adult emergency department (ED) patients, to identify factors associated with admission and to calculate direct medical cost.

Methods

Data of 2017 (1st January to 31st December) were collected and analyzed retrospectively using patients’ medical records and hospital invoices. Factors associated with type of hospitalization were identified using appropriate statistics.

Results

A total of 1,214 hospital admissions were included, accounting for 3.6% of all ED admissions. Men (62.2%) and the age group 21–40 years (43.0%) accounted for the largest proportion. Substances most commonly involved were ethanol (52.9%), benzodiazepines (9.7%), cocaine (4.9%), cannabis (4.6%), antidepressants (4.6%) and psychostimulants (4.6%). A total of 4,561 treatment acts were recorded, most commonly monitoring of vital signs (63.6%) and medication and/or intravenous drip administration (62.9%). Patients were discharged home after having received care in the emergency department (ED-amb) in 54.5% of admissions, were admitted to the emergency-department-24-hours-observation unit (ED-24h) or were hospitalized (Hosp) in 24.6% and 20.9% of admissions, respectively. Factors found to be associated with hospitalization type were age, hour of admission, victim location, degree of severity, use of antidotes, involvement of antidepressants, antipsychotics, psychostimulants, benzodiazepines and ethanol. Total cost was €1,512,346 with an average of €1,287 per admission.

Conclusion

Poisonings entail a considerable percentage of patients admitted to an ED and financial burden. In particular, ethanol poisonings account for the largest proportion of all ED admissions. Comparison of our figures with other data is hampered by the heterogeneity in inclusion criteria. Availability of a uniform template would facilitate comparison and allow better monitoring policies for prevention and cost reduction.

Klíčová slova:

Antidepressants – Critical care and emergency medicine – Ethanol – Hospitals – Insurance – Poisoning – Self harm – Psychostimulants


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