The Toxicology Investigators Consortium Case Registry-the 2018 Annual Report

Abstract

The Toxicology Investigators Consortium (ToxIC) Registry was established by the American College of Medical Toxicology (ACMT) in 2010. The Registry collects data from participating sites with the agreement that all bedside medical toxicology consultation will be entered. This tenth annual report summarizes the Registry's 2019 data and activity with its additional 7177 cases. Cases were identified for inclusion in this report by a query of the ToxIC database for any case entered from 1 January to 31 December 2019. Detailed data was collected from these cases and aggregated to provide information which included demographics, reason for medical toxicology evaluation, agent and agent class, clinical signs and symptoms, treatments and antidotes administered, mortality, and whether life support was withdrawn. 50.7% of cases were female, 48.5% were male, and 0.8% were transgender. Non-opioid analgesics was the most commonly reported agent class, followed by opioid and antidepressant classes. Acetaminophen was once again the most common agent reported. There were 91 fatalities, comprising 1.3% of all Registry cases. Major trends in demographics and exposure characteristics remained similar to past years' reports. Sub-analyses were conducted to describe exposures in cases of self-harm, gender differences in substance use disorder, and trends in addiction medicine and pain management consultations.

The Toxicology Investigators Consortium 2020 Annual Report

“…Tables 2 and 3 summarize selective demographics for age and gender and race and ethnicity, respectively. Gender breakdown was similar to recent years [2][3][4][5]. In 2020, 50.6% of cases involved female patients, and 1% involved transgender or gender non-conforming patients (37 female-to-male, 17 male-to-female, 8 gender non-conforming).…”

Regional, national and international datasets: How they improve our understanding of the acute harms associated with prescription medicine misuse

“…36 The Toxicology Investigators Consortium (ToxIC) Registry was established in 2010 by the American College of Medical Toxicology, and collects data on bedside medical toxicology consultations from 71 US-based and two non-US-based collaborating centres in 2018. 37,38 Although a specific pattern of acute harms is not available, the registry is able to provide an insight into the burden of presentations and associated medical toxicology consultations related to prescription medicine misuse/abuse. In the 2018 ToxIC Registry annual report, of the 7043 medical toxicology consultations undertaken in 2018, 3690 (52.4%) related to 'intentional exposure to a pharmaceutical' and of these consultations, 17.0% (627) were due to misuse/abuse of the pharmaceutical.…”

“…In the 2018 ToxIC Registry annual report, of the 7043 medical toxicology consultations undertaken in 2018, 3690 (52.4%) related to 'intentional exposure to a pharmaceutical' and of these consultations, 17.0% (627) were due to misuse/abuse of the pharmaceutical. 38 In an observational cohort study of 202 adolescents where a medical toxicology consultation was undertaken in relation to 'drug misuse' between January 2010 and June 2013, prescription medicines and over-the-counter medicines were the second and third most common drug groups reported [56 (27. One study from the ToxIC Registry reported on the pattern of acute tramadol toxicity in a series of 80 patients. Those patients who had 'misused' or 'abused' tramadol were more likely to develop seizures than those patients who had used tramadol for other reasons (odds ratio 3.2, 95% confidence intervals 1.2-8.3, p = 0.02).…”

“…The Toxicology Investigators Consortium (ToxIC) Registry was established in 2010 by the American College of Medical Toxicology, and collects data on bedside medical toxicology consultations from 71 US‐based and two non‐US‐based collaborating centres in 2018 37,38 . Although a specific pattern of acute harms is not available, the registry is able to provide an insight into the burden of presentations and associated medical toxicology consultations related to prescription medicine misuse/abuse.…”

“…Although a specific pattern of acute harms is not available, the registry is able to provide an insight into the burden of presentations and associated medical toxicology consultations related to prescription medicine misuse/abuse. In the 2018 ToxIC Registry annual report, of the 7043 medical toxicology consultations undertaken in 2018, 3690 (52.4%) related to ‘intentional exposure to a pharmaceutical’ and of these consultations, 17.0% (627) were due to misuse/abuse of the pharmaceutical 38 . In an observational cohort study of 202 adolescents where a medical toxicology consultation was undertaken in relation to ‘drug misuse’ between January 2010 and June 2013, prescription medicines and over‐the‐counter medicines were the second and third most common drug groups reported [56 (27.7%) and 51 (25.2%) patients respectively] 39 .…”