FACTORS AFFECTING HOSPITAL ADMISSION AND LENGTH OF STAY OF POISONED PATIENTS IN THE NORTH-EAST OF ENGLAND

1 Poisoning is a common reason for presentation to hospital and hospit al admission but there is no agreed policy for managing these patients . This study examined the management of patients presenting with poiso ning and the factors affecting the probability of hospital admission a nd prolonged stay. 2 Data on all cases of poisoning presenting to six Accident and Emergency departments in the North East of England over 1 2 weeks in 1994 was collected prospectively from A&E notes. Length of stay and outcome were recorded from hospital computer records. 3 Overa ll, 73% of patients were admitted to a medical ward. Probability of ad mission was not independently affected by age or gender but was increa sed in those with intentional poisoning (Odds Ratio (OR) 3.3 [95% CI 1 .8, 6.1]), a history of self harm (OR 1.7, [1.0, 2.9]) or potentially hazardous poisoning (OR 3.7 [2.1, 6.6]). There were significant variat ions between hospitals (50-80%) which could not be attributed to case mix. 4 Prolonged stay (>2 nights) was more common in patients over 65 years (OR 6.8 [2.9, 16.1]), those with intentional poisoning (OR 2.7 [ 1.1, 6.6]) and those with potentially hazardous poisoning (OR 2.6 [1.4 , 4.9]). Mean hospital stay was 1.5 days and varied significantly betw een hospitals from 0.8 to 2.1 days and this was independent of case mi x. 5 There are appreciable variations in the management of poisoning b etween hospitals which are not explained by patient characteristics. S avings would occur if rates of admission and duration of stay were red uced by those hospitals where admission is more frequent or hospital s tay is longer. However, the impact of this on long term morbidity is u nknown.