Abstract
Toxicovigilance is the active process of identifying and evaluating the toxic risks existing in a community, and evaluating the measures taken to reduce or eliminate them.ObjectiveThrough a validated toxicovigilance program (SAT-HULP) we examined the characteristics of acute poisoning cases (APC) attended in the Emergency Department (ED) of La Paz Hospital (Madrid, Spain) and assessed their economic impact on the health system.Material and MethodsThe active poisoning surveillance system performs a daily search for cases in the hospital´s computerized case records. Found cases are entered into a database for recording of type of poisoning episode, reasons for exposure, causative agent, signs and symptoms and treatment. We carried out a cross-sectional epidemiological study with analytical projection, based on an impact study on cost per survivor. The data for the costs attributable to cases of APC observed at HULP (outpatients and inpatients) was obtained from the based on the information provided by the diagnosis-related groups (DRG) through the corresponding hospital discharge reports (available through SAT-HULP).ResultsDuring the first 30 month of SAT-HULP operation we found a total of 3,195 APC, a cumulative incidence rate of 1.75% of patients attended in the ED. The mean (SD) patient age was 40.9 (17.8) years and 51.2% were men. Drug abuse accounted for 47.5% of the cases. Suicide attempt was the second most frequent category (38.1%) and other causes accounted for 14.5% of APC. The total cost of hospital care for our hospital rose to €1,825,263.24 (approximately €730,105.30/year) resulting in a permanent occupation of 4 beds/year.ConclusionsSAT-HULP constitutes a validated toxicovigilance tool, which continuously integrates available data in real-time and helps health services manage APC data flexibly, including the consumption of resources from the health system.
Highlights
Toxicovigilance is the active process of identifying and evaluating the toxic risks existing in a community, and evaluating the measures taken to reduce or eliminate them and it is one of the basic tasks of the services involved in caring for patients with poisonings [1,2,3,4,5,6,7]
The data for the costs attributable to cases of acute poisoning cases (APC) observed at HULP was obtained from the based on the information provided by the diagnosis-related groups (DRG) through the corresponding hospital discharge reports
During the first 30 month of SAT-HULP operation we found a total of 3,195 APC, a cumulative incidence rate of 1.75% of patients attended in the Emergency Department (ED)
Summary
Toxicovigilance is the active process of identifying and evaluating the toxic risks existing in a community, and evaluating the measures taken to reduce or eliminate them and it is one of the basic tasks of the services involved in caring for patients with poisonings [1,2,3,4,5,6,7]. The CTU’s initial activities included installing a routine active toxicovigilance system through an automated case detection system based on the digitized clinical reports (SAT-HULP) of patients treated in the Emergency Department of the General Hospital (HED), in other words, adults and adolescents older than 14 years of age. This tool has been properly evaluated and validated [6]. This active poisoning surveillance system performs a daily search for cases in the hospitals computerized case records
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