일개 응급의료센터에 내원한 노인 중독 환자의 중증도 예측인자
Severity Predictors of Elderly Poisoning Patients Admitted to an Emergency Medical Center
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초록
Purpose: This study examined the clinical characteristics of severe elderly poisoning patients to determine the factors that can prevent them. Methods: Data were collected from patients over 65 years of age presenting to the emergency center with poisoning from 2013 to 2018. Their medical records were analyzed retrospectively, and patients with a poisoning severity score of three or more were defined as the severe poisoning group. The risk factors were evaluated by univariate and multivariate analysis. Results: This study analyzed 292 patients, of whom 37 (12.7%) belonged to the severe poisoning group. The severe poisoning group showed a significantly higher association with pesticide poisoning and intentional suicide attempts. Loneliness and somatization were the cause of the suicidal ideas. No significant differences in age, sex, drinking, ingestion time, poisonous materials other than pesticides, and neuropsychological consultation were observed between the two groups. Conclusion: The severe elderly poisoning patients were the result of intentional poisoning for suicide. Loneliness and somatization were the most influential causes of suicidal poisoning. Therefore, psychiatric screening and frequent medical treatment for elderly people are required to prevent severe poisoning in elderly patients.
Abstract
Purpose: This study examined the clinical characteristics of severe elderly poisoning patients to determine the factors that can prevent them. Methods: Data were collected from patients over 65 years of age presenting to the emergency center with poisoning from 2013 to 2018. Their medical records were analyzed retrospectively, and patients with a poisoning severity score of three or more were defined as the severe poisoning group. The risk factors were evaluated by univariate and multivariate analysis. Results: This study analyzed 292 patients, of whom 37 (12.7%) belonged to the severe poisoning group. The severe poisoning group showed a significantly higher association with pesticide poisoning and intentional suicide attempts. Loneliness and somatization were the cause of the suicidal ideas. No significant differences in age, sex, drinking, ingestion time, poisonous materials other than pesticides, and neuropsychological consultation were observed between the two groups. Conclusion: The severe elderly poisoning patients were the result of intentional poisoning for suicide. Loneliness and somatization were the most influential causes of suicidal poisoning. Therefore, psychiatric screening and frequent medical treatment for elderly people are required to prevent severe poisoning in elderly patients.
참고문헌 (31)
- "Daejeon: Annual resport on the prospective population estimates of 2017" (2017)[URL]
- 이운정, "노인 급성 약물 중독 환자의 임상적 고찰", Annals of geriatric medicine and research, 13(1), pp.24~30 (2009), 대한노인병학회
- Persson HE, "Poisoning severity score. Grading of acute poisoning", J Toxicol Clin Toxicol, 36, pp.205~213 (1998)
- Kim JY, "Prognostic Factors of Acute Poisoning in Elderly Patients", J Korean Soc Clin Toxicol, 9, pp.81~87 (2011)
- Miranda Arto P, "Acute poisoning in patients over 65 years of age", An Sist Sanit Navar, 37, pp.99~108 (2014)
- Pillans PI, "Self-poisoning by older Australians : a cohort study", Med J Aust, 206, pp.164~169 (2017)
- Mühlberg W, "Age-dependent changes of the kidneys : pharmacological implications", Gerontology, 45, pp.243~253 (1999)
- Mühlberg W, "Acute poisoning in old and very old patients : A longitudinal retrospective study of 5883 patients in a toxicological intensive care unit", Z Gerontol Geriatr, 38, pp.182~189 (2005)
- Klein-Schwartz W, "Poisoning in the elderly. Epidemiological, clinical and management consideration", Drug Aging, 1, pp.67~89 (1991)
- 정상헌, "중독환자에서 예후 예측 인자로서 중독 중증도 지수의 의의", 대한응급의학회지, 16(6), pp.660~666 (2005), 대한응급의학회
- Kim BK, "Characteristics of elderly patients with acute poisoning", J Korean Soc Clin Toxicol, 8, pp.61~68 (2010)
- Han ST, "Comparative analysis of acute drug intoxication between 1980s and 1990s", J Korean Soc Emerg Med, 10, pp.441~446 (1990)
- Rajasuriar R, "Profile of poisoning admission in Malaysia", Hum Exp Toxicol, 26, pp.73~81 (2007)
- Kim YJ, "Analysis of Clinical Characteristic by Gender in Children and Adolescents with Intensional Poisoning at Emergency Department", J Korean Soc Clin Toxicol, 12, pp.63~69 (2014)
- 이태용, "응급의료센터에 내원한 음독환자의 약물중독 분석", 한국산학기술학회논문지, 11(2), pp.750~757 (2010), 한국산학기술학회
- Williams-Johnson J, "Suicide Attempt by Self-poisoning: Characteristics of Suicide Attempters Seen at the Emergency Room at the University Hospital of the West Indies", West Indian Med J, 61, pp.526~531 (2012)
- Karbakhsh M, "Pattern of poisoning in the elderly : An experience from Tehran", Clin Toxicol, 46, pp.211~217 (2008)
- Doak MW, "Self-poisoning in older adults : patterns of drug ingestion and clinical outcomes", Age Ageing, 38, pp.407~411 (2009)
- 이정열, "강원도 농촌지역의 노인 급성 약물중독 환자에 대한 임상적 고찰", Annals of geriatric medicine and research, 15(4), pp.200~206 (2011), 대한노인병학회
- 안희철, "치매환자에서 발생한 불화수소산 섭취 1예", Annals of geriatric medicine and research, 12(2), pp.112~116 (2008), 대한노인병학회[DOI]
- Seydaoglu G, "Frequency and mortality risk factors of acute adult poisoning in Adana, Turkey, 1997-2002", Mt Sinai J Med, 72, pp.393~401 (2005)
- Srivastava A, "An epidemiological study of poisoning case reported to the National Poisons Information centre, All India Institute of Medical Sciences, New Delhi", Hum Exp Toxicol, 24, pp.279~285 (2005)
- Yang CC, "Taiwan National Posion center : epidemiologic date 1985-1993", J Toxicol Clin Toxicol, 34, pp.651~663 (1996)
- 최규성, "최초 자살시도 방법으로 중독을 선택한 환자의 임상적 특성: 물리적 자해 방법을 사용한 환자와의 비교", 대한응급의학회지, 28(5), pp.493~501 (2017), 대한응급의학회
- 박수빈, "Trends in Suicide Methods and Rates among Older Adults in South Korea: A Comparison with Japan", PSYCHIATRY INVESTIGATION, 13(2), pp.184~189 (2016), 대한신경정신의학회[DOI]
- 민현규, "비 자살목적 의도적 음독환자의 정신과 진료 의뢰가 필요한가?", 대한응급의학회지, 21(6), pp.878~886 (2010), 대한응급의학회
- Kang JH, "A clinical analysis of acute drug intoxication in emergency department setting", J Korean Soc Emerg Med, 10, pp.431~440 (1999)
- 이주환, "응급실에 내원한 약물음독의 자살 시도자에서 정신건강의학과 진료 참여의 제한점", 대한임상독성학회지, 14(1), pp.37~46 (2016), 대한임상독성학회[DOI]
- "Daejeon: Annual resport on the cause of death statisticsof 2017" (2017)[URL]
- Zakharov S, "Suicide attempts by deliberate self-poisoning in children and adolescents", Psychiatry Res, 210, pp.302~307 (2013)
- Kanchan T, "Suicidal poisoning in Southern India : Gender differences", J Forensic Leg Med, 16, pp.362~366 (2009)