Invasive mechanical ventilation among APAP toxicity-related cases presenting to the ED according to age category, 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) | |
|---|---|---|---|---|
| Invasive mechanical ventilation (OR, 95th CI) | Invasive mechanical ventilation (OR, 95th CI) | Invasive mechanical ventilation (OR, 95th CI) | Invasive mechanical ventilation (OR, 95th CI) | |
| Patient characteristics | ||||
| Age | – | 1.26* (1.16 to 1.36) | 1.03* (1.02 to 1.03) | 0.96* (0.95 to 0.98) |
| Female sex | – | 0.46* (0.35 to 0.60) | 0.85* (0.78 to 0.92) | 1.12 (0.84 to 1.50) |
| Payer (vs commercial insurance) | ||||
| Medicare | – | 0.62 (0.15 to 2.58) | 0.82* (0.72 to 0.95) | 1.03 (0.37 to 2.84) |
| Medicaid | – | 0.92 (0.67 to 1.28) | 1.05 (0.94 to 1.17) | 1.52 (0.52 to 4.45) |
| Other | – | 1.01 (0.71 to 1.43) | 0.78* (0.70 to 0.87) | 0.46 (0.12 to 1.79) |
| Income quartile (vs lowest) | ||||
| 2nd quartile | – | 0.92 (0.63 to 1.35) | 1.10 (0.99 to 1.23) | 1.12 (0.76 to 1.65) |
| 3rd quartile | – | 0.92 (0.62 to 1.37) | 1.23* (1.08 to 1.39) | 1.01 (0.69 to 1.48) |
| 4th quartile | – | 0.92 (0.61 to 1.40) | 1.08 (0.95 to 1.24) | 0.91 (0.58 to 1.41) |
| Rural residence | – | 1.96 (0.97 to 3.99) | 1.25 (1.01 to 1.55) | 1.07 (0.55 to 2.10) |
| Hospital characteristics | ||||
| Rural location | – | 0.38* (0.16 to 0.91) | 0.61* (0.47 to 0.77) | 0.57 (0.26 to 1.26) |
| Teaching facility | – | 1.51* (1.12 to 2.03) | 1.10 (0.98 to 1.22) | 1.27 (0.95 to 1.71) |
| Region (vs Northeast) | ||||
| Midwest | – | 0.79 (0.53 to 1.18) | 0.87 (0.75 to 1.01) | 0.88 (0.56 to 1.36) |
| South | – | 0.77 (0.51 to 1.17) | 0.99 (0.86 to 1.15) | 0.90 (0.59 to 1.36) |
| West | – | 0.72 (0.45 to 1.13) | 0.94 (0.81 to 1.08) | 0.90 (0.57 to 1.42) |
| Clinical characteristics | ||||
| Congestive heart failure | – | – | 1.61* (1.17 to 2.21) | 1.39 (0.86 to 2.25) |
| Valvular disease | – | 8.31* (1.91 to 36.10) | 1.12 (0.78 to 1.62) | 0.77 (0.35 to 1.73) |
| Pulmonary circulation disorders | – | – | 2.66* (1.46 to 4.86) | 0.83 (0.27 to 2.53) |
| Peripheral vascular disorders | – | – | 1.25 (0.70 to 2.21) | 1.06 (0.56 to 2.02) |
| Hypertension with complications | – | 2.48* (1.11 to 5.56) | 0.86 (0.54 to 1.36) | 2.01 (0.91 to 4.45) |
| Paralysis | – | OmittedA | 1.95* (1.29 to 2.94) | 0.26 (0.03 to 2.25) |
| Other neurological disorders | – | 7.11* (5.00 to 10.11) | 1.88* (1.66 to 2.13) | 1.10 (0.76 to 1.60) |
| Chronic pulmonary disease | – | 1.79* (1.09 to 2.92) | 1.34* (1.18 to 1.51) | 1.75* (1.26 to 2.44) |
| Diabetes with complications | – | 0.79 (0.13 to 4.81) | 0.91 (0.56 to 1.46) | 0.62 (0.21 to 1.79) |
| Hypothyroidism | – | 0.87 (0.25 to 3.09) | 0.91 (0.75 to 1.11) | 0.56* (0.35 to 0.89) |
| Renal failure | – | 1.78 (0.18 to 17.95) | 1.25 (0.82 to 1.92) | 0.42 (0.19 to 0.94) |
| Liver disease | – | 2.49 (0.44 to 14.03) | 2.23* (1.77 to 2.81) | 2.47* (1.17 to 5.21) |
| AIDS | – | – | 2.11* (1.23 to 3.60) | – |
| Lymphoma | – | – | 1.93 (0.84 to 4.40) | – |
| Metastatic cancer | – | – | 1.68 (0.79 to 3.59) | 0.47 (0.09 to 2.47) |
| Solid tumour | – | – | 0.68 (0.32 to 1.44) | 0.27 (0.06 to 1.22) |
| Rheumatoid arthritis/collagen vascular disease | – | OmittedA | 1.59* (1.18 to 2.14) | 0.48 (0.18 to 1.25) |
| Coagulopathy | – | 2.58* (1.13 to 5.89) | 2.48* (2.10 to 2.94) | 2.17* (1.27 to 3.70) |
| Obesity | – | 0.98 (0.29 to 3.29) | 1.11 (0.91 to 1.36) | 0.49 (0.17 to 1.35) |
| Weight loss/cachexia | – | – | 1.90* (1.43 to 2.53) | 1.92* (1.13 to 3.28) |
| Fluid and electrolyte disorders | – | 5.84* (4.26 to 8.00) | 4.08* (3.75 to 4.43) | 2.26* (1.71 to 3.00) |
| Blood loss or deficiency anaemia | – | 2.07* (1.33 to 3.97) | 1.36* (1.17 to 1.58) | 1.15 (0.79 to 1.67) |
| Alcohol abuse | – | 1.90* (1.34 to 2.71) | 1.26* (1.16 to 1.37) | 0.78 (0.47 to 1.29) |
| Drug abuse | – | 1.50* (1.10 to 2.04) | 1.16* (1.06 to 1.27) | 0.62 (0.32 to 1.18) |
| Psychoses | – | 1.62* (1.12 to 2.35) | 1.51* (1.37 to 1.67) | 1.28 (0.91 to 1.80) |
| Depression | – | 1.10 (0.81 to 1.49) | 1.04 (0.95 to 1.14) | 0.87 (0.61 to 1.23) |
| Intentional self-harm | – | 1.34 (0.96 to 1.87) | 1.49* (1.35 to 1.63) | 2.42* (1.80 to 3.25) |
| Calendar year | ||||
| 2007 (vs 2006) | – | 0.99 (0.64 to 1.55) | 0.99 (0.86 to 1.14) | 1.02 (0.63 to 1.67) |
| 2008 (vs 2006) | – | 0.98 (0.64 to 1.51) | 1.05 (0.92 to 1.20) | 0.81 (0.53 to 1.25) |
| 2009 (vs 2006) | – | 0.94 (0.60 to 1.48) | 0.92 (0.81 to 1.05) | 1.07 (0.69 to 1.65) |
| 2010 (vs 2006) | – | 0.96 (0.63 to 1.46) | 0.95 (0.83 to 1.10) | 1.12 (0.73 to 1.71) |
Omitted A, variable omitted due to near-perfect association with no requirement of intubation (ie, OR<0.01).
*Statistically significant below the computed Simes (1986) false-discovery rate p value (p<0.036).
‘–’, Variable omitted due to small sample size (n≤0.1%); APAP, acetaminophen; ED, emergency department.