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Factors affecting hospital admission and length of stay of poisoned patients in the North East of England

Wolfson Unit of Clinical Pharmacology, University of Newcastle upon Tyne, Newcastle NE2 4HH

S. Lewis

Wolfson Unit of Clinical Pharmacology, University of Newcastle upon Tyne, Newcastle NE2 4HH

L. Bevan

Sunderland District General Hospital, Kayll Rd, Sunderland SR4 7TP

S. Bhattacharyya

Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough TS5 5AZ

MG Bramble

Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough TS5 5AZ

K. Chew

Newcastle General Hospital, Westgate Rd, Newcastle NE4 6BE

J. Connolly

Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough TS5 5AZ

B. Dorani

Newcastle General Hospital, Westgate Rd, Newcastle NE4 6BE

KH Han

Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough TS5 5AZ

JE Horner

Queen Elizabeth Hospital, Sheriff Hill, Gateshead NE9 6SX

A. Rodgers

Dryburn Hospital, North Road, Durham DH1 5TW

B. Sen

Royal Victoria Infirmary, Queen Victoria Road, Newcastle NE1 4LP

B. Tesfayohannes

Sunderland District General Hospital, Kayll Rd, Sunderland SR4 7TP

H. Wynne

Royal Victoria Infirmary, Queen Victoria Road, Newcastle NE1 4LP

DN Bateman

Wolfson Unit of Clinical Pharmacology, University of Newcastle upon Tyne, Newcastle NE2 4HH

1 Poisoning is a common reason for presentation to hospital and hospital admission but there is no agreed policy for managing these patients. This study exam ined the management of patients presenting with poisoning and the factors affecting the probability of hospital admission and prolonged stay.

2 Data on all cases of poisoning presenting to six Accident and Emergency departments in the North East of England over 12 weeks in 1994 was collected prospectively from A&E notes. Length of stay and outcome were recorded from hospital computer records.

3 Overall, 73% of patients were admitted to a medical ward. Probability of admission was not independently affected by age or gender but was increased in those with intentional poisoning (Odds Ratio (OR) 3.3 [95% CI 1.8, 6.1]), a history of self harm (OR 1.7, [1.0, 2.9]) or potentially hazardous poisoning (OR 3.7 [2.1, 6.6]). There were significant variations between hospitals (50 - 80%) which could not be attributed to case mix.

4 Prolonged stay ( > 2 nights) was more common in patients over 65 years (OR 6.8 [2.9, 16.1]), those with intentional poisoning (OR 2.7 [1.1, 6.6]) and those with potentially hazardous poisoning (OR 2.6 [1.4, 4.9]). Mean hospital stay was 1.5 days and varied signifi cantly between hospitals from 0.8 to 2.1 days and this was independent of case mix.

5 There are appreciable variations in the management of poisoning between hospitals which are not explained by patient characteristics. Savings would occur if rates of admission and duration of stay were reduced by those hospitals where admission is more frequent or hospital stay is longer. However, the impact of this on long term morbidity is unknown.

Key Words: poisoning • admission rates • length of hospital stay • outcome

Human & Experimental Toxicology, Vol. 15, No. 11, 915-919 (1996)
DOI: 10.1177/096032719601501109


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