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Acute intoxications: differences in management between six Dutch hospitals.
Caroline Duineveld1, Maurice Vroegop, Lori Schouren
1Radboud University Nijmegen Medical Centre, Pharmacology and Toxicology, PO Box 9101, Nijmegen, Netherlands. c.duineveld@ic.umcn.nl
Clinical Toxicology (Philadelphia, Pa.)
|January 26, 2012
Summary
Hospital admission and treatment for acute intoxications vary significantly across Dutch hospitals, particularly for drug abuse cases. Standardized guidelines are needed to improve patient care efficiency.
Area of Science:
- Clinical Toxicology
- Emergency Medicine
- Public Health
Background:
- Acute intoxications are a common reason for hospital admissions in the Netherlands.
- Existing single-center studies suggest variability in hospital admission and decontamination practices for acute intoxications.
- Lack of clear national guidelines contributes to potential inconsistencies in patient management.
Purpose of the Study:
- To investigate variations in hospital admission rates for acute intoxications among Dutch hospitals.
- To identify differences in decontamination treatment protocols for poisoning patients across these institutions.
- To assess adherence to established guidelines in managing acute poisoning cases.
Main Methods:
- Retrospective data collection from emergency department patient records.
- Inclusion of patients aged over 14 years presenting with acute intoxications between January 1, 2008, and December 31, 2008.
- Analysis of admission rates, causes of intoxication (suicide attempts, drug abuse), and decontamination methods (activated charcoal, gastric lavage).
Main Results:
- Significant variations observed in the percentage of suicide attempts (25-73%) and drug abuse intoxications (18-61%) across hospitals.
- Hospital admission rates for acute intoxications showed marked differences (27-78%), persisting even when stratified by intoxication type.
- Consultation rates with the National Poisons Information Centre varied widely (0% to 80-100%), while activated charcoal use (16.1-42.5%) and gastric lavage (6.6-16.7%) showed no significant inter-hospital differences.
Conclusions:
- Admission rates for acute intoxications, especially those involving drugs of abuse, differ considerably among Dutch hospitals.
- Variability in consultations with poison control centers was noted, contrasting with consistent decontamination rates, suggesting adherence to specific guidelines.
- Implementation of national guidelines or admission algorithms could standardize poisoning management, enhance efficiency, and improve patient outcomes.
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