Poisoning in the elderly is increasing rapidly and is more severe than younger patients

An aging population has resulted in an increasing burden on health care services. We investigated the epidemiology and severity of poisoning in the elderly (≥65 y) population.

Poisoning admissions to a tertiary toxicology service (1990-2024) were extracted. Elderly patients (≥65 y) were compared to non-elderly patients (19-64 y). Data recorded prospectively in a clinical database included demographics, drugs ingested, clinical effects, complications, treatments and outcomes.

There were 1,532 elderly poisoning admissions compared to 24,912 non-elderly admissions. Elderly admissions increased between the first five years (1990-1994) and last five years (2020-2024) from 111 to 449 (5.1-9.8% of all admissions). Elderly patients ingested cardiac medications more often than non-elderly, and fewer psychotropic medications. Median length of stay, intensive care admission, and mortality were higher for elderly patients. All these outcomes improved between the first and last five years: median length of stay decreased from 39 h (interquartile range: 18-77 h) in the first five years to 19 h (interquartile range: 8-39 h) in the last five years; intensive care admission decreased from 29/111 (26%) to 57/449 (13%); and mortality decreased from 5.4% to 1.3%. For the last decade (2015-2024), elderly patients had more cardiac complications (dysrhythmia (4.2% versus 1.3%) and hypotension (8.0% versus 3.4%)) and acute kidney injury (4.2% versus 1.3%), but similar neurological complications (coma and delirium). Morbidity and complications increased with age from 65 to ≥85 y. Elderly patients received more inotropes and dialysis, although less for patients ≥85 y.

Elderly patients had longer hospital stays, more intensive care admissions and cardiac complications, consistent with increased age and medications ingested, but this improved over 35 years. Poisoning severity increased with age, but critical care interventions decreased in patients ≥85 years.

Elderly poisoning cases have rapidly increased, and morbidity and mortality were greater than for non-elderly patients.