Emergency department visits for poisoning in Spanish patients aged 65 years or older: results of the EDENTOX study.

OBJECTIVE

To describe the characteristics of older patients presenting to emergency departments (EDs) with poisoning, as well as its incidence and associated adverse events.

METHODS

All patients aged ≥65years attended over a one-week period in 52 Spanish EDs were included and classified according to whether the ED diagnosis was poisoning. The association between this diagnosis and demographic variables, comorbidity, functional and social status, and chronic treatments was analyzed. Annual incidence was estimated, and its relationship with age and sex was assessed. Short-term adverse events were also evaluated.

RESULTS

A total of 25,557 patients were included, of whom 83 (0.3%) presented with poisoning. The annual incidence was estimated at 191 cases per 100,000 persons aged ≥65years (95%CI: 152-237), with no significant variation according to age. Results were similar when analyzed by sex (incidence 186 [136-248] in women and 210 [148-289] in men; P=.58). Patients with poisoning had higher comorbidity, poorer functional status, and a greater burden of chronic treatments, with no differences in social status. Among poisoned older patients, hospital admission was required in 34.9%, in-hospital mortality was 4.8%, prolonged ED stay (>12hours) among discharged patients occurred in 20.0%, and prolonged hospitalization (>7days) among admitted patients occurred in 58.6%. Within 30days after discharge, 5.6% were hospitalized, 3.9% died, and the composite outcome (hospitalization or death) occurred in 9.7%. Compared with other older ED patients, poisoning was associated with a significantly increased risk of prolonged ED stay (OR: 2.90; 95%CI: 1.45-5.81) and the composite outcome at 30days (OR: 2.53; 95%CI: 1.16-5.54). The association with prolonged ED stay remained significant after adjustment for age, sex, comorbidity, functional status, and chronic medications (adjusted OR: 2.43; 95%CI: 1.18-5.01).

CONCLUSIONS

Poisoning as a reason for ED consultation in older patients is uncommon but occurs in individuals with greater chronic disease burden and is associated with an increased risk of certain adverse outcomes. Epidemiologically, it should be considered a marker of clinical vulnerability.