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.