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Hospitalizations for Pediatric Intoxication in Washington State, 1987-1997
France Gauvin, MD;
Benoît Bailey, MD, MSc;
Susan L. Bratton, MD, MPH
Arch Pediatr Adolesc Med. 2001;155:1105-1110.
Background Intoxication (or poisoning) that necessitates hospitalization remains
an important source of morbidity in children.
Objective To determine changes, during an 11-year period (1987-1997), in the incidence
of hospitalization due to intoxication among children in Washington State
and circumstances of ingestion, agents used, hospital length of stay, charges,
and mortality.
Methods A computerized database of all hospital discharges (Comprehensive Hospital
Abstract Reporting System [CHARS] database) in Washington was used. Cases
included all children younger than 19 years with a primary or secondary diagnosis
for an intoxication or with an external cause of injury code (E code) for
an intoxication from 1987 to 1997.
Results There were 7322 hospitalizations (45 per 100 000 children per year);
the annual rate significantly decreased during the study period. Most patients
(75%) were teenagers. Sixty-five percent were female. Pharmaceutical agents
were used in 80% of cases. Analgesics were the most commonly used (34%), followed
by antidepressants (12%) and psychotropic drugs (8%). Nonpharmaceutical agents
were more prevalent in children younger than 12 years than in teenagers. Self-inflicted
intoxication was the most frequent cause identified by E codes (47%). Median
length of stay was 1 day, and median hospital charges were $2096. Mortality
was low (0.2%) and did not change significantly over time.
Conclusions Acute intoxication continues to be an important cause of hospitalization
in children. The type of agent involved did not change significantly over
time. Teenage girls continue as the highest risk group for suicide attempt
from ingestions. Self-inflicted intoxications were associated with higher
costs, length of stay, and readmissions. Although preventive measures anddevelopment
of poison centers have contributed to decrease mortality from acute intoxication
in children in the last 50 years, efforts need to be targeted toward suicide
prevention, especially among teenage girls.
From the Department of Anesthesiology, University of Washington School
of Medicine and Children's Hospital and Regional Medical Center, Seattle (Drs
Gauvin and Bratton); Divisions of Pediatric Intensive Care (Dr Gauvin), Clinical
Pharmacology and Toxicology (Dr Bailey), and Emergency Medicine (Dr Bailey),
Department of Pediatrics, Hôpital Ste-Justine, Université de
Montréal, Montreal, Quebec; and Department of Pediatrics, University
of Michigan and Mott Children's Hospital, Ann Arbor (Dr Bratton).
Corresponding author and reprints: France Gauvin, MD, Hôpital
Ste-Justine, Department of Pediatrics, 3175 Côte Ste-Catherine, Montreal,
Quebec, Canada H3T 1C5.
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