Özlem BİLİR, Alpaslan ÜNLÜ, Gökhan ERSUNAN, İsmail ATAŞ

Retrospective Analysis of Geriatric Intoxication Cases

Giriş: Yaşla birlikte değişen fizyoloji, özgeçmişte bulunan komorbit hastalıklar ve bu nedenle kullanılan ilaçlar geriatrik yaş grubunda akut zehirlenmeler de çoklu komplikasyonların ortaya çıkmasına neden olur. Bu nüfusta temelde mevcut olan kronik hastalıklar istemli toksik madde alımlarının en sık nedenidir. Materyal-Metod: Bu retrospektif çalışma, üçüncü basamak Eğitim ve Araştırma Hastanesinin Acil Tıp Kliniğine 2009 ve 2019 yılları arasında zehirlenme şüphesi nedeniyle başvuran 60 yaş ve üzeri geriatrik hastaların verileri, hastane bilgi yönetim sistemi üzerinden değerlendirildi. Bulgular: 10 yıllık süre içerisinde zehirlenme nedeniyle acil servise 600 hasta başvurmuş, bunlardan 16’sı (%2.66) geriatrik yaş grubuna aitti. Hastaların yaş aralığı 60 ve 85 yaş arasında değişmekteydi. Yaşa göre dağılıma bakıldığında 80 yaş ve üzerinde 3 hastanın (%18.75) olduğu ve 2 hastanın (%12.5) istemli olarak toksik madde alımı olduğu tespit edildi. İstemeden toksine maruz kalan hastalarda erkek cinsiyet (n=5, %31.5) daha fazlayken isteyerek kasıtlı olarak maruz kalan hastalarda kadın cinsiyet (n=7, %43.75) sayıca fazlaydı. İstemeden toksine maruz kalan hastalarda en fazla koroziv maddeye (n=7, %43.75) maruziyet varken isteyerek kasıtlı olarak maruziyette ise hastaların psikiyatrik hastalıkları nedeniyle aldıkları antipsikotik ilaçların (n=3, %18.75) tedavi dozundan daha yüksek miktarlarda alımı vardı. İsteyerek kasıtlı olarak toksik maddeye maruz kalan 3 hasta, aldıkları toksik maddelerin özellikleri ve ek komorbit hastalıkları olması nedeniyle yatırılarak takip ve tedavileri yapılmış. Tartışma: İstemli olarak toksik maddeye maruziyet tüm yaş gruplarında akut zehirlenmenin baskın nedeniyken geriatrik yaş gruplarında istemsiz maruziyet öyküsü ön plandadır. Ancak 60 yaş ve üzeri nüfusta fiziksel hareket kısıtlılığına neden olan durumlar, depresyon, sosyal izolasyon ya da tedavisi mümkün olmayan hastalıkların varlığı kendi kendine zarar verme duygusunu ortaya çıkartarak intihar girişimine neden olabilmektedir.

Anahtar Kelimeler:

istemli, istemsiz, Geriatrik, Zehirlenme, Öz kıyım

Retrospective Analysis of Geriatric Intoxication Cases

Background: Physiology changing with age, comorbid diseases in the history of the patient and medication used for this reason cause the emergence of multiple complications in acute poisoning in geriatric age group. Chronic diseases basically present in this population are the most important cause of intentional toxic substance intake. Materials and Methods: In this retrospective study, the data of patients aged 60 and older who referred to the Emergency Medicine Clinic of a tertiary Training and Research Hospital between 2009 and 2019 with a suspicion of intoxication were assessed through hospital information management system. Result: 600 patients referred to emergency service for intoxication within a period of 10 years and 16 (2.66%) of these were in geriatric age group. The patients’ age range differed between 60 and 85 years of age. In terms of age distribution, it was found that there were 3 (18.75%) patients aged 80 and older and 2 patients (12.5%) were found to ingest toxic substance intentionally. While male patients who were exposed to toxins unintentionally were higher in number (n=5, 31.5%), the number of patients who were exposed to toxins intentionally were higher among female patients (n=7, 43.75%). While the highest number of unintentional toxic substance exposure occurred with corrosive substance (n=7, 43.75%), the highest number of intentional exposure occurred by taking higher amounts of antipsychotic drugs (n=3, 18.75%) than the therapy dose prescribed for psychiatric diseases. 3 patients who were exposed to toxic substance intentionally were hospitalized and monitored and treated due to the characteristics of the toxic substances they were exposed to and since they had comorbid diseases. Conclusion: Although intentional exposure to toxic substance is the dominant reason for acute intoxication in all age groups, unintentional exposure history is in the foreground in geriatric age groups. However, in 60 years of age and older population, situations which cause limitations in physical movement, depression, social isolation or the presence of diseases which are impossible to treat can cause the emergence of the feeling of self-destruction and result in suicidal attempt.

Keywords:

Geriatric, poisoning, intentional, unintentional, suicide,

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