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Age and Ageing Advance Access originally published online on April 21, 2009
Age and Ageing 2009 38(4):407-411; doi:10.1093/ageing/afp046
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Self-poisoning in older adults: patterns of drug ingestion and clinical outcomes

Martin W. Doak, Andrew C. Nixon, David J. Lupton and W. Stephen Waring

The Scottish Poisons Information Bureau, Royal Infirmary of Edinburgh, Scotland, UK

Address correspondence to: W. Stephen Waring. Tel: +44 (0)131 2421385; Fax: +44 (0)131 2421387. Email: s.waring{at}ed.ac.uk

Background and aims: self-poisoning accounts for a substantial proportion of acute medical hospital presentations, but has been poorly characterised in older adults. This study sought to determine the agents ingested by older adults presenting to hospital after drug overdose, and to compare clinical outcomes to younger patients.

Methods: a retrospective observational study of patients admitted via the emergency department due to drug overdose between 2004 and 2007.

Results: during the study period, there were 8,059 admissions, including 4,632 women (57.5%). This included a subgroup of 361 patients (4.5%) who were >60 years of age. This subgroup was more likely to require hospital stay >1 night, odds ratio (95% confidence interval) = 4.3 (3.6–5.5, P < 0.0001), transfer to a critical care area = 3.8 (1.1–13.0, P = 0.0340) and had higher mortality = 4.8 (1.1–22.1, P = 0.0463). A higher proportion of older patients required transfer to a psychiatric unit (P < 0.0001) or to a general medical ward (P < 0.0001) than younger adults.

Conclusions: older adults that presented to hospital after drug overdose had ingested different drugs than younger patients, possibly due to different prescribing patterns, and had a poorer outcome. The use of drugs associated with significant toxicity should be avoided in older patients at risk of self-harm.

Keywords: antidepressant, clinical outcome, drug toxicity, overdose, toxicology, elderly

Received 22 July 2008; accepted in revised form 23 February 2009.


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Self-Poisoning in Older Adults
Stuart K K Lee, et al.
Age and Ageing, 19 Aug 2009 [Full text]

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