The assessment and management of the poisoned elderly patient is challenging.
The co-existence of limited physiological reserves, deteriorating cognition, multiple medical problems and their multiple prescribed medications provides the basis for exaggerated and unpredictable responses to any toxicological insult. The risk assessment for an overdose in the elderly patient predicts a more severe clinical course for the same agent taken in the same dose by a healthy young adult. Higher levels of vigilance, supportive care and monitoring are necessary. The clinical course of overdose or chronic poisoning is likely to be more severe and also have a higher complication rate. Age is highly correlated with case fatality rate and it is estimated that each 10-year increase in age is associated with a 36% increase in the odds ratio for death as an outcome following poisoning. Elderly patients are more likely to require hospital care as a result of accidental exposures and adverse drug effects.
- Roger JJ, Heard K. Does age matter? Comparing case fatality rates for selected poisonings reported to U.S. poison centers. Clinical Toxicology 2007; 45:705-708.