Self-poisoning by older Australians: a cohort study

Area of Science:

• Geriatric Medicine
• Toxicology
• Public Health

Background:

• Self-poisoning is a significant public health concern, particularly among vulnerable populations.
• Understanding the epidemiology and severity of self-poisoning in older adults is crucial for targeted interventions.

Purpose of the Study:

• To investigate the epidemiology and severity of self-poisoning among older adults (≥65 years) in Australia.
• To compare self-poisoning data in older adults with those of younger adults.

Main Methods:

• A 26-year cohort study (1987-2012) of patients presenting to a tertiary toxicology center.
• Data collected included hospital length of stay (LOS), drug types ingested, intensive care unit (ICU) admissions, and in-hospital deaths.

Main Results:

• Older adults (626 patients, 3.6%) had longer median LOS (34h vs 16h) and higher ICU admission rates (21.2% vs 11.9%) compared to younger adults.
• Mortality was higher in older patients (3.8% vs 0.6%), though it declined over time. Hypotension and arrhythmias were more common in older patients.
• While benzodiazepines were common, opioids were frequent in fatal cases. Toxic ingestion of cardiovascular drugs increased threefold; about one-third of poisonings in older adults were unintentional or iatrogenic.

Conclusions:

• Older patients exhibit more severe outcomes from self-poisoning than younger adults.
• Key differences include increased hospital LOS, higher ICU admission rates, and greater mortality.
• Self-poisoning in older adults warrants specific attention due to its distinct characteristics and severity.