Descriptive statistics of ED cases associated with APAP toxicity according to age category in the USA, 2006–2010
| Age 11 years and below (N=42 623) | Age 12–20 years (N=106 725) | Age 21–64 years (N=246 640) | Age 65 years and above (N=15 893) | Overall (N=411 881) | |
|---|---|---|---|---|---|
| Patient characteristics | |||||
| Age (mean±SD) | 2.2±1.7 | 16.9±2.1 | 36.4±11.4 | 75.2±7.9 | 29.3±17.6 |
| Female sex | 48.3% | 74.8% | 64.4% | 68.0% | 65.5% |
| Payer, commercial insurance | 38.1% | 26.4% | 20.4% | 1.6% | 23.1% |
| Medicare | ≤0.1% | 0.2% | 10.0% | 88.3% | 9.5% |
| Medicaid | 48.9% | 51.5% | 35.1% | 7.8% | 39.7% |
| Other | 12.8% | 21.8% | 34.5% | 2.3% | 27.7% |
| Income quartile, lowest | 24.3% | 23.2% | 28.1% | 24.4% | 26.3% |
| 2nd quartile | 28.3% | 27.5% | 28.5% | 27.0% | 28.2% |
| 3rd quartile | 25.5% | 25.6% | 24.5% | 25.4% | 24.9% |
| 4th quartile | 21.9% | 23.8% | 18.9% | 23.3% | 20.6% |
| Rural residence | 19.6% | 16.7% | 17.1% | 17.9% | 17.3% |
| Hospital characteristics | |||||
| Region, Northeast | 14.4% | 16.2% | 15.6% | 16.4% | 15.6% |
| Midwest | 25.6% | 18.2% | 26.4% | 21.0% | 26.6% |
| South | 32.1% | 30.0% | 34.7% | 34.5% | 33.2% |
| West | 18.1% | 25.6% | 23.3% | 28.2% | 24.5% |
| Rural facility | 18.5% | 15.3% | 15.3% | 16.2% | 15.6% |
| Teaching facility | 38.9% | 39.9% | 39.5% | 35.7% | 39.4% |
| Clinical characteristics | |||||
| Congestive heart failure | ≤0.1% | ≤0.1% | 0.7% | 8.8% | 0.8% |
| Valvular disease | ≤0.1% | ≤0.1% | 0.6% | 3.3% | 0.5% |
| Pulmonary circulation disorders | ≤0.1% | ≤0.1% | 0.2% | 1.4% | 0.2% |
| Peripheral vascular disorders | ≤0.1% | ≤0.1% | 0.3% | 3.8% | 0.3% |
| Hypertension with complications | ≤0.1% | ≤0.1% | 0.7% | 7.6% | 0.7% |
| Paralysis | ≤0.1% | ≤0.1% | 0.4% | 1.5% | 0.3% |
| Other neurological disorders | 0.3% | 2.2% | 7.4% | 14.6% | 5.6% |
| Chronic pulmonary disease | 2.0% | 4.9% | 7.8% | 19.2% | 6.9% |
| Diabetes with complications | ≤0.1% | ≤0.1% | 0.5% | 2.0% | 0.4% |
| Hypothyroidism | ≤0.1% | 0.5% | 2.9% | 11.9% | 2.3% |
| Renal failure | ≤0.1% | ≤0.1% | 0.8% | 7.3% | 0.8% |
| Liver disease | ≤0.1% | 0.2% | 2.2% | 1.7% | 1.4% |
| HIV/AIDS | ≤0.1% | ≤0.1% | 0.2% | ≤0.1% | ≤0.1% |
| PUD, excluding bleeding | ≤0.1% | ≤0.1% | ≤0.1% | ≤0.1% | ≤0.1% |
| Lymphoma | ≤0.1% | ≤0.1% | ≤0.1% | ≤0.1% | ≤0.1% |
| Metastatic cancer | ≤0.1% | ≤0.1% | ≤0.1% | 1.0% | 0.2% |
| Solid tumour | ≤0.1% | ≤0.1% | 0.3% | 2.1% | 0.2% |
| Rheumatoid arthritis/collagen vascular disease | ≤0.1% | ≤0.1% | 0.9% | 3.1% | 0.7% |
| Coagulopathy | ≤0.1% | 0.5% | 2.3% | 4.2% | 1.7% |
| Obesity | ≤0.1% | 1.2% | 3.3% | 2.4% | 2.4% |
| Weight loss/cachexia | ≤0.1% | ≤0.1% | 0.8% | 3.2% | 0.6% |
| Fluid and electrolyte disorders | 0.7% | 8.1% | 17.2% | 29.4% | 13.6% |
| Blood loss or deficiency anaemia | ≤0.1% | 1.5% | 4.3% | 12.3% | 3.4% |
| Alcohol abuse | ≤0.1% | 5.7% | 19.8% | 8.6% | 13.7% |
| Drug abuse | ≤0.1% | 12.1% | 20.3% | 6.3% | 15.6% |
| Psychoses | ≤0.1% | 11.2% | 19.8% | 13.3% | 15.3% |
| Depression | ≤0.1% | 27.4% | 28.4% | 22.6% | 25.0% |
| No Elixhauser comorbidities present | 96.4% | 47.0% | 25.7% | 12.6% | 38.0% |
| Intentional self-harm | ≤0.1% | 71.4% | 64.2% | 34.9% | 58.4% |
| Calendar year | |||||
| 2006 | 18.1% | 21.1% | 19.5% | 17.5% | 19.7% |
| 2007 | 21.0% | 20.5% | 19.6% | 17.0% | 19.9% |
| 2008 | 21.8% | 21.1% | 20.6% | 20.1% | 20.8% |
| 2009 | 20.8% | 19.7% | 20.4% | 21.8% | 20.3% |
| 2010 | 18.3% | 17.6% | 20.0% | 23.6% | 19.3% |
| Outcomes | |||||
| Disposition, treat-and-release | 92.7% | 38.4% | 28.1% | 23.8% | 37.4% |
| Transfer | 2.5% | 22.4% | 14.0% | 6.3% | 14.7% |
| Admission | 2.9% | 37.0% | 55.1% | 66.0% | 45.4% |
| Death | ≤0.1% | ≤0.1% | 0.7% | 3.4% | 0.6% |
| Other | 1.9% | 2.2% | 1.9% | 0.5% | 1.9% |
| Average ED and inpatient charge (US$ 2014) (mean±SD) | $1343±3162 | $7884±13 034 | $15 824±31 404 | $28 631±50 515 | $12 766±28 414 |
| Annual: total national bill (US$ 2014) (mean±SD) | $11.45 million | $168.28 million | $789.11 million | $91.00 million | $1059.86 million |
| 2006–2010: total national bill (US$ 2014) (mean±SD) | $0.06 billion | $0.84 billion | $3.95 billion | $0.46 billion | $5.30 billion |
| Inpatient length of stay (mean±SD) | 1.8±1.8 | 2.3±2.2 | 3.2±4.5 | 4.9±6.9 | 3.1±4.4 |
| Invasive mechanical ventilation | ≤0.1% | 1.2% | 6.8% | 8.6% | 4.7% |
| ED visits per 100 000 persons per year* | 17.29 | 63.17 | 27.77 | 8.18 | 27.10 |
| Inpatient admissions per 100 000 persons per year* | 0.50 | 23.34 | 15.50 | 5.68 | 12.46 |
*Base US populations for 2006–2010 obtained from the Centers for Disease Control and Prevention, National Vital Statistics System, Vintage 2012 bridged-race postcensus US resident population estimates.
APAP, acetaminpophen; ED, emergency department; PUD, peptic ulcer disease.