급성 약물 중독 환자에서 의도성 여부에 따른 임상적 분석 = Clinical Analysis of Acute Drug Poisoning Victims by Intentional Poisoning

다국어 초록 (Multilingual Abstract)

Purpose: Korea has one of the highest suicide rates of countries belonging to the Organization for Economic Cooperation and Development (OECD). In development of emergency medical services (EMS) and emergency medicine in Korea, one of the characteristics of suicide in Korea is the means of committing suicide, which is intentional acute drug poisoning. The aim of this study is to compare the characteristics of acute drug poisoning victims between intentional poisoning and accidental poisoning.
Methods: A retrospective study was conducted for the year 2011. The study group included adults (over 16 years old)with acute drug poisoning. We followed the American Association of Poisoning Control Center definition of acute poisoning. Exclusion criteria were 1) a victim of adverse effect of therapeutic dose, 2) a victim of chronic exposure,3) missing data on emergency medical records, and 4)unknown cause of poisoning. During the study period, 195patients were enrolled.
Results: In comparison between the intentional poisoning group and the unintentional poisoning group, no statistical difference was observed in mean age, sex ratio, initial vital signs in the emergency department (ED), and time from exposure to ED. However, the initial mental state in the ED,transportation, previous suicide history, ED treatment,length of stay in the ED, and Poisoning Severity Score (PSS) showed statistical difference (p<0.05).
Conclusion: We concluded that intentional drug poisoning is associated with more serious progress and outcome than unintentional poisoning in a group of Korean adults.
Prevention and public education will be needed in order to decrease the rate of suicide poisoning in Korea.

참고문헌 (Reference)

1 조준호, "자살시도자에 대한 진료 체계 및 응급의학과-정신과 의료진의 인식 비교" 대한응급의학회 19 (19): 535-540, 2008

2 민현규, "비 자살목적 의도적 음독환자의 정신과 진료 의뢰가 필요한가?" 대한응급의학회 21 (21): 878-886, 2010

3 "http://www.nso.go.kr/"

4 Na BH, "The regional analysis of drug poisoning in emergency room" 6 : 107-112, 1995

5 Yang CC, "Taiwan National Poison Center: epidemiologic data 1985-1993" 34 : 651-663, 1996

6 Qin P, "Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981-1997" 160 : 765-772, 2003

7 Stewart SE, "Suicidal children and adolescents with first emergency room presentations: predictors of six-month outcome" 40 : 580-587, 2001

8 Kapur N, "Self-poisoning suicide deaths in England: could improved medical management contribute to suicide prevention?" 103 : 765-775, 2010

9 Eddleston M, "Self poisoning with pesticides" 328 : 42-44, 2004

10 Persson HE, "Poisoning severity score. Grading of acute poisoning" 36 : 205-213, 1998

11 Bentur Y, "Poisoning in Israel: annual report of the Israel Poison Information Center, 2007" 10 : 749-756, 2008

12 Hong JP, "Korea Annual Report of Suicide" Korea Association for Prevention Suicide 29-35, 2011

13 Repetto MR, "Epidemiology of poisoning due to pharmaceutical products, Poison Control Centre, Seville, Spain" 13 : 353-356, 1997

14 Eddleston M, "Epidemiology of intentional self-poisoning in rural Sri Lanka" 187 : 583-584, 2005

15 Sorodoc V, "Epidemiology of acute drug poisoning in a tertiary center from Iasi County, Romania" 30 : 1896-1903, 2011

16 Crawford MJ, "Does initial management affect the rate of repetition of deliberate self harm? cohort study" 317 : 985-, 1998

17 Oh SH, "Deliberate self-poisoning: factors associated with recurrent self-poisoning" 29 : 908-912, 2011

18 Kim SG, "Clinical comparison of acute poisoning victims between urban and rural areas" 8 : 69-78, 2010

19 Kim HJ, "Association of prescribed drug intoxication and neuropsychiatric history" 9 : 77-88, 2011

20 Bronstein AC, "2010 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 28th Annual Report" 49 : 910-941, 2011

21 So BH, "2008 Database of Korean toxic exposure: a preliminary study" 8 : 51-60, 2010