UMEM Educational Pearls

Category: Toxicology

Title: Predictors of fatality from intentional drug overdose

Keywords: risk of death, intentional drug overdose (PubMed Search)

Posted: 1/23/2020 by Hong Kim, MD, MPH
Click here to contact Hong Kim, MD, MPH

 

Intentional drug overdose (IDO) can lead to significant morbidity and can increased patient's risk of death. A study was recently performed to identify the predictors of death in a cohort of patient who intentionally overdose on drug(s). 

National Self-Harm Registry and National Drug-Related Death Index were reviewed (between January 1st, 2007 and December 31st, 2014) to identify the study cohort.

Results

 

Non fatal IDO

Fatal IDO

Number of cases

63,831

364

Incidence 

148.8/100,000

1.01/100,000

Male

42.0%

55.2%

Age, years (median)

35

44

Multiple drug ingestion

48.5%

78.3%

 

Risk of death

  • 1.7 times higher in MALE compared to female
  • 5 times higher in age > 45 years vs. 15-24 years
  • 3 times higher in patient who ingested 2 – 5 distinct agents, 6x higher in > 6 agent vs. single agent
  • 15 times higher after TCA ingestion
  • 12 times higher after opioids ingestion
  • 4 times higher after antidepressants or illicit substance ingestion/exposure

Conclusion

  • Older age (> 45 years), male gender and ingestion of multiple agents (>2) were associated with higher risk of death from intention drug overdose.

References

International Journal of Drug Policy76https://doi.org/10.1016/j.drugpo.2019.102609