Table 2

Patient disposition of admission or mortality versus treat-and-release from APAP toxicity-related presentation to the ED, 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)
Admission (RRR, 95th CI)Mortality (RRR, 95th CI)Admission (RRR, 95th CI)Mortality (RRR, 95th CI)Admission (RRR, 95th CI)Mortality (RRR, 95th CI)Admission (RRR, 95th CI)Mortality (RRR, 95th CI)
Patient characteristics
 Age1.11** (1.03 to 1.19)1.09*** (1.06 to 1.11)1.49* (1.01 to 2.19)1.01*** (1.01 to 1.02)1.05*** (1.04 to 1.06)1.00 (0.99 to 1.01)1.09** (1.03 to 1.14)
 Female sex1.01 (0.77 to 1.33)0.97 (0.89 to 1.06)1.94 (0.28 to 13.60)0.90*** (0.85 to 0.95)0.96 (0.76 to 1.22)1.24 (0.99 to 1.56)0.54 (0.25 to 1.15)
 Payer (vs commercial insurance)
  Medicare0.54* (0.30 to 0.97)OmittedA0.83** (0.75 to 0.92)0.87 (0.59 to 1.28)1.17 (0.49 to 2.78)0.12** (0.03 to 0.55)
  Medicaid0.62** (0.45 to 0.86)0.97 (0.87 to 1.07)0.42 (0.09 to 1.85)1.02 (0.94 to 1.11)0.90 (0.64 to 1.27)0.64 (0.25 to 1.69)0.04** (0.01 to 0.28)
  Other0.58* (0.37 to 0.92)0.86* (0.76 to 0.98)0.32 (0.07 to 1.46)0.90* (0.83 to 0.98)0.87 (0.62 to 1.22)0.31* (0.10 to 0.93)OmittedA
 Income quartile (vs lowest)
  2nd quartile1.12 (0.79 to 1.59)1.13* (1.00 to 1.27)2.50 (0.21 to 29.40)1.05 (0.97 to 1.14)0.93 (0.67 to 1.28)0.84 (0.61 to 1.14)0.23* (0.07 to 0.74)
  3rd quartile0.75 (0.48 to 1.16)1.15* (1.02 to 1.29)13.40* (1.59 to 113.21)1.08 (0.98 to 1.20)1.21 (0.86 to 1.69)1.08 (0.75 to 1.54)1.03 (0.32 to 3.24)
  4th quartile0.90 (0.58 to 1.39)1.24** (1.07 to 1.43)OmittedA1.26*** (1.13 to 1.41)1.20 (0.83 to 1.73)1.18 (0.83 to 1.69)1.76 (0.64 to 4.85)
 Rural residence2.26* (1.19 to 4.30)1.30* (1.06 to 1.60)0.82 (0.18 to 3.78)1.24** (1.07 to 1.44)1.21 (0.72 to 2.03)1.36 (0.76 to 2.43)1.88 (0.44 to 7.97)
Hospital characteristics
 Rural location0.53 (0.26 to 1.12)0.79* (0.62 to 0.99)1.48 (0.15 to 14.19)0.67*** (0.56 to 0.80)0.42** (0.21 to 0.81)0.63 (0.35 to 1.14)1.27 (0.34 to 4.68)
 Teaching facility3.13*** (2.17 to 4.50)1.55*** (1.35 to 1.79)5.08 (0.82 to 31.72)0.98* (0.86 to 1.12)1.04 (0.79 to 1.37)1.31* (1.03 to 1.68)1.58 (0.68 to 3.66)
 Region (vs Northeast)
  Midwest0.72 (0.47 to 1.12)0.96 (0.81 to 1.14)1.18 (0.11 to 13.16)0.87 (0.72 to 1.04)0.59* (0.40 to 0.90)0.63* (0.44 to 0.90)0.48 (0.16 to 1.45)
  South0.79 (0.51 to 1.22)0.85 (0.72 to 1.02)1.92 (0.17 to 21.10)0.86 (0.72 to 0.99)0.79 (0.55 to 1.14)0.85 (0.61 to 1.18)0.36* (0.14 to 0.92)
  West0.65 (0.39 to 1.08)0.62*** (0.52 to 0.74)0.39 (0.01 to 12.73)0.51*** (0.43 to 0.59)0.52** (0.35 to 0.77)0.54** (0.38 to 0.77)0.26* (0.08 to 0.82)
Clinical characteristics
 Congestive heart failure1.48 (0.95 to 2.31)1.67 (0.80 to 3.49)3.36*** (2.01 to 5.63)1.64 (0.55 to 4.87)
 Valvular disease3.94* (1.15 to 13.50)OmittedA4.47*** (2.70 to 7.40)2.06 (0.60 to 7.01)3.64** (1.67 to 7.92)3.55 (0.51 to 24.58)
 Pulmonary circulation disorders2.35* (1.03 to 5.40)8.50** (2.54 to 28.43)3.70 (0.39 to 35.40)OmittedA
 Peripheral vascular disorders3.15*** (1.55 to 6.37)2.64 (0.59 to 11.89)2.88** (1.32 to 6.28)5.77 (0.96 to 34.48)
 Hypertension with complications2.46*** (1.53 to 3.96)OmittedA2.27** (1.32 to 3.92)1.66 (0.59 to 4.68)5.74*** (2.32 to 14.21)0.66 (0.06 to 6.75)
 Paralysis1.54 (0.31 to 7.54)OmittedA3.28*** (1.90 to 5.65)11.47*** (4.84 to 27.23)1.75 (0.57 to 5.38)1.20 (0.14 to 10.13)
 Other neurological disorders24.83*** (10.48 to 58.83)3.14*** (2.40 to 4.12)50.97***(10.75 to 241.71)2.19*** (1.95 to 2.47)2.21*** (1.55 to 3.15)1.97*** (1.40 to 2.78)1.48 (0.67 to 3.27)
 Chronic pulmonary disease1.94 (0.95 to 3.96)2.35*** (1.93 to 2.86)OmittedA2.01*** (1.78 to 2.28)1.29 (0.83 to 2.00)3.21*** (2.27 to 4.54)5.16** (1.75 to 15.25)
 Diabetes with complications0.97 (0.58 to 1.64)OmittedA4.52*** (2.55 to 8.01)3.57* (1.01 to 12.64)2.34 (0.62 to 8.88)16.60 (0.12 to 225.36)
 Hypothyroidism1.04 (0.58 to 1.85)OmittedA2.67*** (2.16 to 3.31)1.52 (0.77 to 2.99)2.15*** (1.43 to 3.24)2.17 (0.75 to 6.33)
 Renal failure2.11 (0.24 to 18.52)OmittedA2.39*** (1.51 to 3.80)3.16** (1.38 to 7.25)0.50 (0.22 to 1.12)1.06 (0.13 to 8.44)
 Liver disease2.98* (1.03 to 8.64)OmittedB12.13*** (5.98 to 24.60)47.89*** (21.53 to 106.52)OmittedBOmittedB
 HIV/AIDS2.18 (0.82 to 5.83)6.86* (1.35 to 34.92)
 Lymphoma1.43 (0.60 to 3.43)4.24 (0.69 to 25.95)
 Metastatic cancer6.08*** (2.22 to 16.67)30.32*** (8.35 to 110.18)3.18 (0.78 to 13.04)1.76 (0.29 to 10.55)
 Solid tumour1.97* (1.09 to 3.55)5.77** (2.13 to 15.59)2.41 (0.98 to 5.915.46 (0.94 to 31.63)
 Rheumatoid arthritis/collagen vascular disease0.80 (0.21 to 3.07)OmittedA2.66*** (1.89 to 3.76)2.28 (0.95 to 5.43)3.32* (1.24 to 8.90)OmittedA
 Coagulopathy21.75*** (7.70 to 61.42)178.62*** (10.96 to 291.11)16.06*** (9.70 to 26.57)72.42*** (39.91 to 131.40)OmittedBOmittedB
 Obesity6.29*** (3.95 to 10.01)OmittedA4.96*** (3.32 to 6.27)5.55*** (3.08 to 10.02)5.43** (1.68 to 17.54)0.10 (0.01 to 1.37)
 Weight loss20.51*** (7.35 to 57.18)25.74*** (7.64 to 86.71)19.01** (2.50 to 144.65)283.59*** (17.45 to 468.08)
 Fluid and electrolyte disorders20.75*** (9.22 to 46.70)6.78*** (5.70 to 8.07)8.91** (2.48 to 31.96)7.97*** (7.09 to 8.96)28.45*** (21.84 to 37.07)9.77*** (6.85 to 13.92)56.28*** (22.19 to 142.71)
 Blood loss or deficiency anaemia13.27** (2.65 to 66.38)4.17*** (2.83 to 6.15)OmittedA4.46*** (3.64 to 5.46)3.34*** (2.22 to 5.04)2.64*** (1.72 to 4.04)0.15 (0.01 to 4.35)
 Alcohol abuse2.32*** (1.94 to 2.77)1.16 (0.09 to 14.53)2.53*** (2.33 to 2.75)1.75*** (1.34 to 2.29)2.96*** (1.76 to 4.95)3.27 (0.71 to 15.09)
 Drug abuse2.02*** (1.77 to 2.30)3.02 (0.59 to 15.37)2.37*** (2.17 to 2.59)1.58** (1.17 to 2.13)1.71 (0.96 to 3.04)0.59 (0.06 to 5.44)
 Psychoses5.13*** (4.48 to 5.89)4.46 (0.91 to 21.85)4.44*** (4.00 to 4.93)1.42 (1.00 to 2.03)6.41*** (3.88 to 10.57)6.46 (0.84 to 49.84)
 Depression1.71*** (1.55 to 1.88)3.46 (0.94 to 12.70)1.75*** (1.62 to 1.89)1.10 (0.82 to 1.48)1.95*** (1.44 to 2.64)1.88 (0.79 to 4.49)
 Intentional self-harm3.40*** (3.07 to 3.77)OmittedB3.03*** (2.81 to 3.26)1.69*** (1.30 to 2.21)4.89*** (3.59 to 6.64)8.57*** (3.97 to 18.49)
Calendar year
 2007 (vs 2006)0.78 (0.48 to 1.28)0.92 (0.80 to 1.06)0.95 (0.17 to 5.34)0.99 (0.88 to to 1.11)1.01 (0.69 to 1.49)1.29 (0.92 to 1.81)1.97 (0.39 to 9.87)
 2008 (vs 2006)0.79 (0.49 to 1.26)0.79** (0.68 to 0.92)0.65 (0.07 to 5.73)0.82** (0.72 to 0.94)0.82 (0.56 to 1.21)0.94 (0.67 to 1.32)3.13 (0.96 to 10.19)
 2009 (vs 2006)0.67 (0.40 to 1.11)0.84* (0.72 to 0.98)0.30 (0.03 to 3.17)0.87 (0.77 to 1.00)0.58* (0.38 to 0.88)0.79 (0.55 to 1.13)2.23 (0.65 to 7.64)
 2010 (vs 2006)0.74 (0.45 to 1.22)0.88 (0.74 to 1.03)0.56 (0.06 to 5.18)0.83** (0.73 to 0.95)0.78 (0.53 to 1.13)1.03 (0.74 to 1.45)2.57 (0.72 to 9.18)
  • OmittedA, variable omitted due to near-perfect association with survival (ie, OR<0.01).

  • OmittedB, variable omitted due to near-perfect association with mortality (ie, RRR>10 000).

  • ***Statistically significant at p<0.001.

  • **Statistically significant at p<0.01.

  • *Statistically significant at p<0.05.

  • –, Variable omitted due to small sample size (n≤0.1%); APAP, acetaminophen; ED, emergency department; RRR, relative risk ratio.