1. Poisoning and envenomation linkage to evaluate outcomes and clinical variation in Australia (PAVLOVA): a longitudinal data-linkage cohort of acute poisonings, envenomations, and adverse drug reactions in New South Wales, Australia, 2011-2020.
- Author
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Cairns R, Noghrehchi F, Raubenheimer JE, Chitty KM, Isbister GK, Chiew AL, Brett J, Dawson AH, Brown JA, and Buckley NA
- Subjects
- Humans, Female, Male, Middle Aged, New South Wales epidemiology, Adult, Adolescent, Young Adult, Child, Aged, Child, Preschool, Infant, Longitudinal Studies, Bites and Stings epidemiology, Drug-Related Side Effects and Adverse Reactions epidemiology, Aged, 80 and over, Hospitalization statistics & numerical data, Cohort Studies, Infant, Newborn, Poisoning epidemiology
- Abstract
Introduction: Poisoning is a leading cause of morbidity and mortality that is increasing in many countries. Better data are needed to understand epidemiology and outcomes of poisoning. This work describes a new poisoning data linkage cohort in New South Wales, Australia (population approximately 8 million)., Methods: This is a longitudinal health record linkage, 2011-2020, including data from: ambulance call-outs, emergency department presentations, hospital admissions, death registrations, the poisons centre, and four tertiary toxicology units. Individuals with poisoning, venomous animal/plant exposures, or adverse drug reaction events were included., Results: There were 845,217 linkable events relating to 400,642 ambulance, 688,484 emergency department, 682,013 admission, 40,456 toxicology, and 11,879 death records. There were 572,841 people with events; the median age at the time of first event was 57 years, and 51.9% were female. Events leading to patient admission were most commonly adverse drug reactions ( n = 511,263), intentional poisonings ( n = 68,646), unintentional poisonings ( n = 54,840) and animal/plant exposures ( n = 11,092). Demographics varied by cause: intentional poisoning (median age 33 years, 61.7% female); unintentional poisoning/animals/plants (median age 43 years, 45% female); and adverse drug reactions (median age 70 years, 54% female). Adolescent females had highest rates of intentional poisoning, while unintentional poisoning had a bimodal distribution, highest in children <5 years old and males aged 20 to 50 years. Substance use disorders were documented comorbidities for 44% of intentional poisoning, 29% of unintentional poisoning, and 13% of adverse drug reaction-related admissions; mood disorders were documented for 54%, 17% and 10% of these admissions, respectively., Discussion: Poisonings and hospitalised adverse drug reactions are common in New South Wales, affecting approximately 8% of the population in 10 years. This linkage improves understanding of poisoning risks and outcomes in Australia., Conclusions: This novel data linkage provides a unique opportunity to study poisoning across multiple settings for an individual over an extended period.
- Published
- 2024
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