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Differences in poisoning cases according to patient’s place of origin

Clemente Rodríguez C, Echarte Pazos JL, Aguirre Tejedo A, Puente Palacios I, Iglesias-Lepine ML, Supervía Caparrós A

Servicio de Urgencias. Hospital Universitario del Mar. Parc de Salut Mar. Barcelona, Spain. Servicio de Urgencias. Consorci Hospitalari Parc Taulí. Sabadell. Barcelona, Spain.

Objective: To study the characteristics of poisoning cases treated in a hospital
emergency department according to patient’s place of birth.
Methods: In 2003 and 2004 for all poisoning cases we collected data on patients’
country of origin, type and place of poisoning, treatment, and destination on discharge.
Variables were compared according to national origin: Spanish vs other places of origin,
specifically Eastern Europea (EE), Latin America (LA), or North Africa (NA).
Results: Data on 1287 poisoning cases were available. Non-Spanish emergency
poisoning patients were younger than Spanish patients (29.6 vs 35.8 years, P<.001). The
percentages of men in each group were different as follows: NA, 74.5%; EE, 62.9%,
Spanish, 55.3%, and LA, 47.9% (P=.023). More Spanish poisoning cases were related to
attempted suicide (29.8% vs 20.7% in other groups) rather than use of recreational
drugs (62.3% of Spaniards vs 72.1% of others) (P=.007). Non-Spanish patients were
poisoned more often in public places (68.1% vs 53.2% of Spanish cases), while Spanish
patients’ poisonings occurred more often in the home (44.4% vs 28.3%) (P<.001). It
was more common for Spanish patients to have been poisoned on previous occasions
(50.7% vs 30.4% of others, P<.001) and to have a history of mental illness (58.3% vs
31.6% of others; P<.001). Spanish patients had more drug overdoses, of a single drug
(24.2% vs 14.5% of others, P=.001) or of a drug in association with alcohol (8.7% vs
4.3% of others, P=.017). Patients from other countries were more often poisoned by
alcohol overdose (34.1% vs 24.4% of Spaniards, P=.001) or by home cleaning products
(5.1% vs 2.2% of Spaniards, P=.01). A psychiatric evaluation was made for 38.3% of the
Spanish nationals and 22.8% of the foreign nationals (P<.001). The rates of
gastrointestinal decontamination were also different (Spanish, 13.2% vs other, 6.9%;
P=.008). Spanish patients had to be admitted more often (10.5% vs 5.1% of others,
P=.004) and more often had prolonged stays in the emergency department (25.6% vs
16.4% of others, P=.008). The Spanish and LA patient profiles were similar.
Conclusions: Poisonings of patients from countries other than Spain more often
occurred in public places and were caused by alcohol or home cleaning products or
recreational drugs. Poisoning patients born in other countries were less likely to have a
history of prior poisoning or mental illness and were less often admitted, kept for
prolonged periods in the emergency department, or evaluated by a psychiatrist.

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