Factors associated with rapidly repeated acute poisoning by substances of abuse: a prospective observational cohort study

Objective

We have previously found that 9% of patients treated for acute poisoning by substances of abuse in a primary care emergency outpatient setting presented with a new poisoning within a week. We now identify factors associated with rapidly repeated acute poisoning by substances of abuse.

Results

In 169/1952 (9%) cases of acute poisoning by substances of abuse included consecutively from October 2011 through September 2012 at a primary care emergency outpatient clinic in Oslo, Norway, the patient re-presented within a week with a new poisoning. Homeless patients were more likely to re-present, adjusted odds ratio (AOR) 2.0 (95% confidence interval (CI) 1.3–3.2, p = 0.003), as were self-discharging patients, AOR 1.7 (95% CI 1.2–2.4, p = 0.007), and patients with an opioid as main toxic agent, AOR 1.5 (95% CI 1.0–2.3, p = 0.028). There was no statistically significant association between rapid re-presentation and severe mental illness or suicidal intention.

Poisonings in the Nordic countries in 2007: a 5-year epidemiological follow-up

AIM

To map mortality and morbidity of poisonings in Denmark, Finland, Iceland, Norway and Sweden in 2007 and undertake a comparison with a corresponding study in 2002.

METHODS

Morbidity was as for 2002 defined as acute poisoning (ICD-10 codes, main and subsidiary diagnoses) treated in hospitals. The figures were extracted from the National Patient/Hospital Registers. Deaths recorded as acute poisoning (using corresponding ICD-10 codes) were collected from the National Cause of Death Registers.

RESULTS

Annual mortality of acute poisonings per 100,000 inhabitants (rate) for 2007 was 22.4 in Finland, an important increase from 16.7 per 100,000 in 2002. The increase was mainly due to a change in coding of alcohol, but also represented a slight increase in fatal alcohol intoxications per se. The poisoning death rate in the other Nordic countries varied between 8-13 and was at the same level as for 2002. The morbidity rates for 2007 between 158-285 per 100,000 inhabitants represented a slight increase compared to 2002 figures.

CONCLUSION

The increase in poisoning death rate for alcohol, and thus total rate in Finland in 2007 compared to 2002, has further increased the gap to the other Nordic countries. Poisoning morbidity rates in the Nordic countries are of the same level, but the variability shown indicates that more harmonization and collaboration is needed to increase the data quality.