4). In the remaining cases of suicide, a spectrum of toxic agents was used. Ethanol was the second most common main toxic agent in accidental deaths (11%). Table 4 Evaluated Dinaciclib manufacturer intention and main toxic agents in fatal poisonings in Oslo during one year. Anti-depressants (SSRIs, TCAs, or others) were found as the main or additional toxic agent in 28 (27%) of the deaths: 15 (22%) of men, and 13 (38%) of women. Thirty-one per cent of those who committed suicide had taken anti-depressants (n = 10), as had 25% of those with accidental death (n = 18). Among those Inhibitors,research,lifescience,medical who were alcohol dependent, 42% (n = 5) had taken anti-depressants.
Seventeen per cent of illegal drug abusers had used anti-depressants (n = 9), whereas 50% Inhibitors,research,lifescience,medical of those abusing prescription drugs had used such agents (n = 3). Toxic agents in fatal vs. non-fatal acute poisonings During the study period, 2998 acute poisoning episodes were registered in Oslo. Of these, 103 were fatal, of whom one episode were recognized as result of fatal poisoning only at the autopsy, and therefore not included in studies presented earlier [4,12]. The percentage of deaths per acute poisoning episode
was 3% in total (95% C.I., 0.03-0.04). Opiates or opioids were the main Inhibitors,research,lifescience,medical toxic agent in the majority of the fatal poisonings, whereas ethanol, opiates or opioids, and benzodiazepines dominated among those who survived the acute poisoning episode (Table (Table5).5). The case fatality rate was 0.07 or 7% for opiates or opioids Inhibitors,research,lifescience,medical (95% C.I., 0.06-0.09) and 0.9% for ethanol (95% C.I., 0.004-0.02). Acute poisonings caused by methanol, TCAs, and antihistamines resulted most often in fatal poisonings when the total number of such poisonings was taken into account. Methanol poisoning was fatal in 33% Inhibitors,research,lifescience,medical of the cases (95% C.I., 0.008-0.91), TCAs in 14% (95% C.I., 0.04-0.33), and antihistamines in 10% (95% C.I., 0.02-0.27)
of all registered poisoning episodes by these substances, respectively. Table 5 Comparison of main toxic agents between fatal and non-fatal acute poisonings during one year in Oslo. Discussion Three per cent of all acute poisonings were fatal. Previous studies of acute poisonings have focused else on in-hospital mortality [15,16], although a register-based study for the whole of Norway found that 80% of deaths occurred outside hospital [11]. In the present study from Oslo, the mortality rate was 24 per 100 000 inhabitants, whereas the register-based study including all of Norway found a lower mortality rate (10.8 per 100 000) [11]. This may indicate a higher mortality rate in Oslo, an urban setting, which usually has a larger population of drug addicts compared with the average of the whole country, including rural areas. However, it may also indicate that retrospective register-based studies tend to underestimate mortality.