The Toxicology Investigators Consortium Case Registry—The 2011 Experience

In 2010, the American College of Medical Toxicology established its Case Registry, the Toxicology Investigators Consortium (ToxIC). ToxIC is a prospective registry, which exclusively compiles suspected and confirmed toxic exposure cases cared for at the bedside by medical toxicologists at its partic...

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Bibliographic Details
Published in:Journal of medical toxicology 2012-12, Vol.8 (4), p.360-377
Main Authors: Wiegand, Timothy J., Wax, Paul M., Schwartz, Tayler, Finkelstein, Yaron, Gorodetsky, Rachel, Brent, Jeffrey
Format: Article
Language:English
Subjects:
Acetaminophen
Acetaminophen - poisoning
Acetylcysteine
Acetylcysteine - therapeutic use
Adolescent
Adult
Aged
Analgesics
Analgesics, Non-Narcotic - poisoning
Analgesics, Opioid - poisoning
Antidepressants
Antidepressive Agents - poisoning
Antidotes
Aspirin
Biomedical and Life Sciences
Biomedicine
Cannabinoids
Child
Child, Preschool
Consortia
Databases, Factual
Drug abuse
Drug Overdose - epidemiology
Emergency medical services
Emergency Service, Hospital
Ethanol
Exposure
Fatalities
Female
Flumazenil
Heroin
Humans
Hypnotics
Male
Medical records
Medical research
Middle Aged
Naloxone
Narcotics
Opioids
Oxycodone
Oxycodone - poisoning
Pharmacology/Toxicology
Physostigmine
Prospective Studies
Psychotropic drugs
Psychotropic Drugs - poisoning
Registries
Salts
Sodium bicarbonate
Stimulants
Substance-Related Disorders - epidemiology
Sympathomimetics
Toxicity
Toxicology
Toxicology Investigation
Trends
Venom
Young Adult
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Description
Summary:In 2010, the American College of Medical Toxicology established its Case Registry, the Toxicology Investigators Consortium (ToxIC). ToxIC is a prospective registry, which exclusively compiles suspected and confirmed toxic exposure cases cared for at the bedside by medical toxicologists at its participating sites. The Registry aims to fulfill two important gaps in the field: a real-time toxicosurveillance system to identify current poisoning trends and a powerful research tool in toxicology. ToxIC allows extraction of information from medical records making it the most robust multicenter database on chemical toxicities in existence. All cases seen by medical toxicologists at participating institutions were entered in a database. Information characterizing patients entered in 2011 was tabulated. 2010 data was also included so that cumulative total numbers could be described as well. The current report is a summary of the data collected in 2011 in comparison to 2010 entries and also includes cumulative data through December 31st, 2011. During 2011, 28 sites with 49 specific institutions contributed a total of 6,456 cases to the Registry. The total number of cases entered into the registry at the end of 2011 was 10,392. Emergency departments remained the most common source of consultations in 2011, accounting for 53 % of cases. The most common reason for consultation was for pharmaceutical overdoses, which occurred in 48 % of patients, including intentional (37 %) and unintentional (11 %) exposures. The most common classes of agents were sedative–hypnotics (1,492 entries in 23 % of cases), non-opioid analgesics (1,368 cases in 21 % of cases), opioids (17 %), antidepressants (16 %), stimulants/sympathomimetics (12 %), and ethanol (8 %). N -acetylcysteine was the most commonly administered antidote during 2011, similar to 2010, followed by the opioid antagonist naloxone, sodium bicarbonate, physostigmine and flumazenil. Anti-crotalid Fab fragments (CroFab) were administered in 106 out of 131 cases in which an envenomation occurred. There were 35 deaths recorded in the Registry during 2011. The most common associated agents, including when reported as sole agent or in combination with other agents, were opioids and analgesics (acetaminophen, aspirin, NSAIDS) with ten and eight deaths, respectively. Oxycodone was reported in six of the ten opioid-related deaths and heroin in three. Acetaminophen was the most common single agent reported overall being identified in
ISSN:1556-9039
1937-6995
DOI:10.1007/s13181-012-0264-9