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Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011

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Abstract

In recent years, there has been an increase in poisoning-related emergency department (ED) visits. This study examines trends in ED resource utilization for poisoning-related visits over time. A retrospective review of data from the National Hospital Ambulatory Medical Care Survey, 2003–2011, was conducted. All ED visits with a reason for visit or ICD-9 code related to poisoning were included. We examined the number of ED visits and resources used including diagnostic studies and procedures performed, medications provided, admission rates, and length of stay. The proportion of visits involving resource use was tabulated and trends analyzed using survey-weighted logistic regression, grouping into 2-year periods to ensure adequate sample size. Of an estimated 843 million ED visits between 2003 and 2011, 8 million (0.9 %) were related to poisoning. Visits increased from 1.8 million (0.8 %) visits in 2003–2004 to 2.9 million (1.1 %) visits in 2010–2011, p = 0.001. Use of laboratory studies, EKGs, plain radiographs, and procedures remained stable across the study period. CT use was more than doubled, increasing from 5.2 to 13.7 % of visits, p = 0.001. ED length of stay increased by 35.5 % from 254 to 344 min, p = 0.001. Admission rates increased by 45.3 %, from 15.0 to 21.8 %, p = 0.046. Over the entire study period, 52.0 % of poisoned patients arrived via ambulance, and 3.0 % of patients had been discharged from the hospital within the previous 7 days. Poisoning-related ED visits increased over the 8-year study period; poisonings are resource-intensive visits and require increasingly longer lengths of ED stay or hospital admission.

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC, 20010, USA

    Maryann Mazer-Amirshahi & Christie Sun

  2. Georgetown University School of Medicine, Washington, DC, USA

    Maryann Mazer-Amirshahi

  3. George Washington University School of Medicine and Health Sciences, Washington, DC, USA

    Peter Mullins

  4. Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Jeanmarie Perrone

  5. Department of Emergency Medicine, New York University, New York, NY, USA

    Lewis Nelson

  6. Department of Emergency Medicine, George Washington University, Washington, DC, USA

    Jesse M. Pines

  7. Center for Clinical Practice Innovation, George Washington University, Washington, DC, USA

    Jesse M. Pines

Authors
  1. Maryann Mazer-Amirshahi
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  2. Christie Sun
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  3. Peter Mullins
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  4. Jeanmarie Perrone
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  5. Lewis Nelson
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  6. Jesse M. Pines
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Correspondence to Maryann Mazer-Amirshahi.

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No funding was provided for this study.

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The authors have no financial relationships relevant to this article to disclose.

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The authors declare that they have no conflicts of interest.

Additional information

Presented as an abstract at the American College of Medical Toxicology (ACMT) Annual Scientific Meeting, Huntington Beach, CA, March 2016, and at the Society for Academic Emergency Medicine (SAEM) Annual Meeting, New Orleans, LA, May 2016.

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Mazer-Amirshahi, M., Sun, C., Mullins, P. et al. Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011. J. Med. Toxicol. 12, 248–254 (2016). https://doi.org/10.1007/s13181-016-0564-6

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  • DOI: https://doi.org/10.1007/s13181-016-0564-6

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