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dc.contributor.authorBuckley, Nicholas
dc.date.accessioned2021-03-26T05:24:34Z
dc.date.available2021-03-26T05:24:34Z
dc.date.issued2015en_AU
dc.identifier.urihttps://hdl.handle.net/2123/24748
dc.description.abstractObjective: To examine inhospital mortality and morbidity associated with self-poisoning with different drug classes over an extended period. Design, setting and participants: A prospective cohort study over 26 years (1987–2012) with limited follow-up of patients presenting consecutively to a primary and tertiary referral toxicology centre covering Newcastle, Lake Macquarie and Port Stephens, Australia. Main outcome measures: Hospital length of stay, types of drugs ingested, intensive care unit (ICU) admission, requirement for ventilation, inhospital deaths and rates of antidepressant drug use in Australia. Results: Over the study period, there were 17 266 admissions of patients poisoned by 34 342 substances (16 723 drugs available only on prescription). The median length of stay was 16 hours, 12.2% of patients (2101/17 266) were admitted to an ICU, 7.4% (1281/17 266) were ventilated and 78 (0.45%) died in hospital. Patient demographics, social and psychiatric factors remained stable over the 26-year period, but case fatality decreased (from 0.77% [15/1955] to 0.17% [7/4060]) as did ICU admissions (19.2% [376/1955] to 6.9% [280/4060]), ventilation (13.7% [268/1955] to 4.8% [193/4060]) and LOS. The most frequently ingested substances were alcohol, benzodiazepines, paracetamol, antidepressants and antipsychotics. There was a substantial fall in some highly toxic drugs (tricyclic antidepressants, barbiturates, conventional antipsychotics and theophylline), but increases in less toxic selective serotonin reuptake inhibitors, serotonin–noradrenaline reuptake inhibitors and paracetamol. A greater than sixfold increase in community antidepressant use was accompanied by only minor changes in overall and antidepressant selfpoisoning rates. Conclusion: Over two decades, there were decreases in poisonings by many highly toxic drugs which were associated with substantial reductions in morbidity and inhospital deaths. Despite massive increases in the number of antidepressant prescriptions, neither rates of self-harm nor the proportion of antidepressant poisonings increased markedly.en_AU
dc.language.isoenen_AU
dc.publisherMJAen_AU
dc.relation.ispartofMedical journal of australiaen_AU
dc.rightsCopyright All Rights Reserveden_AU
dc.titleA prospective cohort study of trends in selfpoisoning, Newcastle, Australia, 1987–2012: plus ça change, plus c’est la même choseen_AU
dc.typeArticleen_AU
dc.subject.asrc1115 Pharmacology and Pharmaceutical Sciencesen_AU
dc.identifier.doi10.5694/mja14.01116
dc.relation.nhmrc1055176
dc.relation.nhmrc1061041
dc.relation.nhmrc1059542
usyd.facultySeS faculties schools::Faculty of Medicine and Healthen_AU
usyd.departmentpharmacologyen_AU
usyd.citation.volume202en_AU
usyd.citation.issue8en_AU
usyd.citation.spage438en_AU
usyd.citation.epage443en_AU
workflow.metadata.onlyNoen_AU


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