Abstract

Background: The objective of this study was to describe inpatient prevalence, characteristics, outcomes, and resource use for acute salicylate intoxication hospitalizations in the United States. Methods: A total of 13,805 admissions with a primary diagnosis of salicylate intoxication from 2003 to 2014 in the National Inpatient Sample database were analyzed. Prognostic factors for in-hospital mortality were determined using multivariable logistic regression. Results: The overall inpatient prevalence of salicylate intoxication among hospitalized patients was 147.8 cases per 1,000,000 admissions in the United States. The average age was 34 ± 19 years. Of these, 35.0% were male and 65.4% used salicylate for suicidal attempts. Overall, 6% required renal replacement therapy. The most common complications of salicylate intoxication were electrolyte and acid-base disorders, including hypokalemia (25.4%), acidosis (19.1%), and alkalosis (11.1%). Kidney failure (9.3%) was the most common observed organ dysfunction. In-hospital mortality was 1.0%. Increased in-hospital mortality was associated with age ≥30, Asian/Pacific Islander race, diabetes mellitus, hyponatremia, ventricular arrhythmia, kidney failure, respiratory failure, and neurological failure, while decreased in-hospital mortality was associated with African American and Hispanic race. Conclusion: hospitalization for salicylate intoxication occurred in 148 per 1,000,000 admissions in the United States. Several factors were associated with in-hospital mortality.

Highlights

  • Salicylates have been used for more than 3000 years as an analgesic

  • The median hospitalization cost per patient was USD 11,172 (Table 1). This is a large hospitalized cohort study investigating inpatient prevalence, characteristics, in-hospital outcomes, and resource use for patients admitted for salicylate intoxication

  • We identified independent factors associated with increased in-hospital mortality, including ventricular arrhythmia/cardiac arrest, respiratory failure, age ≥30, Asian/Pacific Islander race, hyponatremia, diabetes mellitus, kidney failure, and neurological failure

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Summary

Introduction

Salicylates have been used for more than 3000 years as an analgesic. Salicylate intoxication is one of the most common drug overdoses. The American Association of Poison Control Centers reports the annual burden of salicylate intoxication. In the United States in 2018, 27,644 patients were exposed to salicylates (both acetylsalicylate and methyl salicylate) with an associated 0.4% mortality rate. The objective of this study was to describe inpatient prevalence, characteristics, outcomes, and resource use for acute salicylate intoxication hospitalizations in the United States. Results: The overall inpatient prevalence of salicylate intoxication among hospitalized patients was 147.8 cases per 1,000,000 admissions in the United States. Conclusion: hospitalization for salicylate intoxication occurred in 148 per 1,000,000 admissions in the United States.

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