Effect of age and sex on the risk for suicide and psychotropic agent poisoning

UVOD: Akutna otrovanja čest su uzrok prijema bolesnika u službu hitne medicinske pomoći, kako u svijetu tako i u Republici Hrvatskoj. Otrovanja se često navode kao najčešći način samoubojstva ili pokušaja samoubojstva. Najviše slučajeva uključuje predoziranje drogom, benzodiazepinima, antidepresivima i neurolepticima. Od izuzetnog je značaja da svaka zemlja ustanovi svoj obrazac otrovanja (koje se supstance i na koji način najčešće koriste i kako se ti bolesnici prezentiraju). ----- BOLESNICI I METODE: U ovoj studiji učinjena je prospektivna analiza medicinske dokumentacije bolesnika koji su u hitnom prijemu Kliničkog bolničkog centra “Sestre milosrdnice” u Zagrebu liječeni zbog akutnog otrovanja. Zabilježeni slučajevi analizirani su prema etiološkim i demografskim karakteristikama (dob i spol). ----- REZULTATI: Od ukupnog broja analiziranih bolesnika koji iznosi 1661, 2001. godine dokumentiran je 331, 2010. godine 669 i 2015. godine 661 bolesnik. Usporedivši medijan dobi za 2001. godinu s medijanom dobi za 2010. i 2015. godinu uočeno je da su 2001. godine otrovani mlađi bolesnici (medijan dobi 28 godina) dok su 2010. i 2015. godine otrovani nešto stariji bolesnici (medijan dobi 42 godine)(p<0,01). Kroz sve tri analizirane godine uočeno je da su se žene više trovale s namjerom samoubojstva (65,8 vs. 34,2 ; p<0,01), dok su se muškarci predominantno trovali s ciljem namjernog predoziranja (77% vs. 23% ; p<0,01). Nefarmacima pretežito su se trovali muškarci (72,8 vs. 27,2 ; p<0,01) dok su se žene više trovale lijekovima s djelovanjem na živčani sustav (53,5 vs. 46,5 ; p<0,01). Sveukupno kroz tri analizirane godine najčešće sredstvo otrovanja bio je etanol kojeg su po učestalosti slijedili anksiolitici, antipsihotici, metadon i buprenorfin.INTRODUCTION: Acute poisoning is a common cause of hospital admissions, both in the world and in Republic of Croatia. Poisonings are often referred as the most common way of suicide or attempted suicide. Most cases include overdose with drugs, benzodiazepines, antidepressants and neuroleptics. It is of the utmost importance that each country establishes its own poisoning pattern (to determine which substances are most commonly used and how these patients are presented). ----- PATIENTS AND METHODS: In this study a prospective analysis of patients medical records was performed. Patients included is this study were admitted to emergency department of Sisters of Charity University Hospital in Zagreb with diagnosis of acute poisoning. Recorded cases were analyzed according to etiologic and demographic characteristics (age and sex). ----- RESULTS: Of all analyzed patients (1661), there was 331 patient in 2001, 669 patients in 2010 and 661 patient in 2015. Comparing median age in 2001 with median ages in 2010 and 2015, we noticed that in 2001 younger patients (median age 28) were poisoned in comparison to 2010 and 2015 where slightly older patients were poisoned (median age 42) (p<0,01). Through all three analyzed years, women were found to be more intentional of suicide (65,8 vs. 34,2 ; p<0,01), while male gender was predominantly found to deliberately overdose (77% vs. 23% ; p<0,01). Men were predominantly poisoned with non-pharmacological drugs (72,8 vs. 27,2 ; p<0,01) while women had more poisonings with medications that affect the nervous system (53,5 vs. 46,5 ; p