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Hospitalizations for acetaminophen overdose: a Canadian population-based study from 1995 to 2004
Robert P Myers1, Bing Li, Andrew Fong
1Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada. rpmyers@ucalgary.ca
Insights
Acetaminophen overdose hospitalizations decreased overall, especially intentional overdoses. However, accidental overdoses rose, and older adults, females, Aboriginals, and those on social assistance remain at high risk for acetaminophen overdose.
Area of Science:
- Public Health
- Toxicology
- Epidemiology
Background:
- Acetaminophen overdose (AO) is a leading cause of acute liver failure.
- Understanding temporal trends and risk factors for AO is crucial for public health interventions.
Purpose of the Study:
- To examine temporal trends in hospitalization rates for acetaminophen overdose (AO).
- To identify sociodemographic risk factors associated with AO in a large Canadian health region.
Main Methods:
- Retrospective analysis of 1,543 patients hospitalized for AO.
- Data collected from administrative records in the Calgary Health Region between 1995 and 2004.
Main Results:
- Hospitalization rates for AO decreased by 41% from 1995 to 2004.
- Intentional overdoses significantly declined, while accidental overdoses showed an increasing trend after 2002.
- Key risk factors identified include female sex, Aboriginal status, and receipt of social assistance.
Conclusions:
- Hospitalization rates for AO, particularly intentional ingestions, have declined in the study region.
- Younger populations, females, Aboriginal individuals, and those receiving social assistance face the highest risk for AO.
Background:
Acetaminophen overdose (AO) is the most common cause of acute liver failure. We examined temporal trends and sociodemographic risk factors for AO in a large Canadian health region.
Methods:
1,543 patients hospitalized for AO in the Calgary Health Region (population ~1.1 million) between 1995 and 2004 were identified using administrative data.
Results:
The age/sex-adjusted hospitalization rate decreased by 41% from 19.6 per 100,000 population in 1995 to 12.1 per 100,000 in 2004 (P < 0.0005). This decline was greater in females than males (46% vs. 29%). Whereas rates fell 46% in individuals under 50 years, a 50% increase was seen in those >/= 50 years. Hospitalization rates for intentional overdoses fell from 16.6 per 100,000 in 1995 to 8.6 per 100,000 in 2004 (2004 vs. 1995: rate ratio [RR] 0.49; P < 0.0005). Accidental overdoses decreased between 1995 and 2002, but increased to above baseline levels by 2004 (2004 vs. 1995: RR 1.24;P < 0.0005). Risk factors for AO included female sex (RR 2.19; P < 0.0005), Aboriginal status (RR 4.04; P < 0.0005), and receipt of social assistance (RR 5.15; P < 0.0005).
Conclusion:
Hospitalization rates for AO, particularly intentional ingestions, have fallen in our Canadian health region between 1995 and 2004. Young patients, especially females, Aboriginals, and recipients of social assistance, are at highest risk.
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