Trends in children's attendance at hospital Accident and Emergency Departments for unintentional poisoning from 1990 to 1999 in the UK

Patel, Bakula; Kendrick, Denise; Groom, Lindsay

doi:10.1080/17457300500089020

Cited by 7 publications

(16 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The static rate of unintentional poisonings shown is consistent with that demonstrated among 10-14 year olds between 1990-1999 from UK ED data [8] but contrary to the reduction among 10-17 year olds shown from primary care data alone between 1992-2012. [5] Our failure to show a significant downward trend may relate to the relatively small number of unintentional poisonings and a lack of statistical power to demonstrate such a change.…”

Section: What Is Already Known On This Topicsupporting

confidence: 72%

“…[11,[18][19][20] Poisonings among 10-14 year olds in the US were shown to reduce from 1993-95 to 2000-04, [7] but increase in the UK among 15-19 year olds from 1987/8 to 1992/3 [6] and 10-17 year olds between 1992 and 2012. [5] The existing literature examining this temporal relationship is, however, either out of date and based on single data sources [6][7][8] or likely to have significantly underestimated incidence. [5] Indeed most adolescent poisoning epidemiology studies to date have examined data from single hospitals or emergency departments [6,7,11,12,[21][22][23][24][25] with few using national hospitalisation, [8,16,17] poison centre, [26] or large primary care datasets including data on primary and secondary care service use.…”

Section: What Is Already Known On This Topicmentioning

confidence: 99%

“…[5] The existing literature examining this temporal relationship is, however, either out of date and based on single data sources [6][7][8] or likely to have significantly underestimated incidence. [5] Indeed most adolescent poisoning epidemiology studies to date have examined data from single hospitals or emergency departments [6,7,11,12,[21][22][23][24][25] with few using national hospitalisation, [8,16,17] poison centre, [26] or large primary care datasets including data on primary and secondary care service use. [5,9] What this study adds This is one of the largest population-based studies to date examining adolescent poisoning epidemiology, while CPRD is broadly representative of the demographics of the UK population.…”

Section: What Is Already Known On This Topicmentioning

confidence: 99%

“…[10,14] Our rates are consistently higher than those reported from solely primary care, [5] hospitalisation [6,7,22,28] or ED attendance data. [8,29] We must consider whether the increase in intentional poisonings demonstrated is real or instead linked to changing coding practices or hospitalisation thresholds. For example, The National Institute for Health and Care Excellence (NICE) issued guidance in 2004 suggesting all under-16s with a selfharm episode be admitted to hospital for further assessment.…”

Section: What Is Already Known On This Topicmentioning

confidence: 99%

“…[5] The existing literature examining poisoning time trends among young people is, however, either out of date or based on single data sources. [5][6][7][8] We previously reported poisoning incidence rates amongst 0-24 year olds from 1998-2011 using a large primary care dataset linked to hospitalisation data and found strong socio-economic gradients in all age groups. However time-trends or social gradients were not explored by poisoning intent.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Differing patterns in intentional and unintentional poisonings among young people in England, 1998–2014: a population-based cohort study

et al. 2016

Self Cite

View full text Add to dashboard Cite

Background: Accurate and up to date data on changes in poisoning incidence among young people are lacking. Recent linkage of UK primary care, hospital and mortality data allows these to be quantified to inform service delivery.Methods: An open cohort study of 1,736,527 young people aged 10-24 between 1998-2014 was conducted using linked data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics deaths. Incidence rates by poisoning intent were calculated by age, sex, deprivation and year.Results: Total poisoning incidence rates increased by 25% from 1998/99-2013/14 (adjusted incidence rate ratio (aIRR) 1.25, 95%CI 1.20-1.30). Patterns differed markedly by intent. Intentional poisoning rates increased by 52% while unintentional rates remained unchanged. Intentional rates increased almost exclusively among females, gradually between 1998/99 and 2013/14 among 16-18 (88% increase) and 19-24 (36% increase) year olds but only increased among 10-15 year olds in the last 2 years (79% increase). A two-fold increased risk of poisoning for the most compared to least deprived quintile existed (aIRR 2.21, 95%CI 2.02-2.23) and remained over time. Conclusions:Commissioning of primary and secondary prevention services needs to address the growing problem of intentional poisonings among young people.

show abstract

Section: What Is Already Known On This Topicsupporting

confidence: 72%

Section: What Is Already Known On This Topicmentioning

confidence: 99%

Section: What Is Already Known On This Topicmentioning

confidence: 99%

Section: What Is Already Known On This Topicmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Differing patterns in intentional and unintentional poisonings among young people in England, 1998–2014: a population-based cohort study

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

Acute poisoning in children under the age of six: a two‐decade study of hospital admissions and trends

2013

View full text Add to dashboard Cite

show abstract

Can a spuriously raised creatinine by Jaffe method be helpful in poisoning?

Lakin¹,

Booth²,

McCann

et al. 2011

Pediatrics International

View full text Add to dashboard Cite

We report the case of a 2-year-old girl who accidentally ingested model car fuel (nitromethane). As there was a possibility that this was in fact ethylene glycol, blood investigations were performed. These were normal except for a creatinine of 274 mmol/L. Nitromethane interferes with the Jaffe method of creatinine estimation, which was confirmed by two alternative methods of analysis. Our patient's creatinine normalized after 36 h. This case highlights the importance of being aware of a raised creatinine in this situation and accurately identifying any poison in question. Case reportA previously well, 2-year-old girl presented to Accident and Emergency having ingested an unknown quantity of a blue liquid presumed to be model vehicle fuel. Although there was debate about whether this was ethylene glycol, her parents confirmed it was nitromethane. Vital signs and physical examination were unremarkable. As she was asymptomatic she was admitted for observation. Due to the possibility that the liquid was ethylene glycol, which would have required definitive treatment, blood investigations, including renal function and osmolar gap, were sent.Blood investigations revealed a creatinine of 274 mmol/L (normal 35-62) and the remainder of the blood investigations were normal (Table 1). Given that there was no history suggestive of renal disease and that the biochemistry was otherwise normal, a second blood sample was obtained. This was taken at approximately 12 h once the initial sample was rechecked and advice was obtained from the UK National Poisons Centre. This confirmed an isolated raised creatinine of 234 micromol/L.It was suspected that this was due to the previously reported phenomenon of the interference with the standard "Jaffe" method of creatinine estimation. To confirm this, the blood samples were sent for comparative analysis, at an external laboratory, using two alternative creatinine-specific methods 3,4 : mass spectrometry and enzymatic measurement. The results are summarized in Table 2 and confirm interference with the standard method.During her admission our patient remained clinically well. Although not formally measured, there were no clinical concerns regarding her urine output. Her urine was not biochemically assessed. She was discharged the following day with a plan to return 48 h after ingestion to have her renal function rechecked. When our patient returned her creatinine was normalizing and had normalized a week later. DiscussionThis case highlights that poisoning remains a common clinical problem and it is a significant cause of morbidity in children. Between 1993 and 1999 there were an estimated 15 106 attendances to Accident and Emergency for poisoning in children due to ingestion of solvents or fuels in the UK. 1 Nitromethane is an organic compound that is commonly used as a solvent and as a fuel for high-performance vehicles. Its acute toxic potential is low, although it may cause skin and eye irritation, respiratory and gastrointestinal disturbance and central nervous system (CNS) depression...

show abstract

Trends in children's attendance at hospital Accident and Emergency Departments for unintentional poisoning from 1990 to 1999 in the UK

Cited by 7 publications

References 3 publications

Differing patterns in intentional and unintentional poisonings among young people in England, 1998–2014: a population-based cohort study

Differing patterns in intentional and unintentional poisonings among young people in England, 1998–2014: a population-based cohort study

Acute poisoning in children under the age of six: a two‐decade study of hospital admissions and trends

Can a spuriously raised creatinine by Jaffe method be helpful in poisoning?

Contact Info

Product

Resources

About