The Toxicology Investigators Consortium Case Registry—the 2015 Experience

Lynn A. Farrugia, Sean H. Rhyee, Sharan L. Campleman, Anne Michelle Ruha, Timothy Weigand, Paul M. Wax, Jeffrey Brent, behalf of the Toxicology Investigators Consortium On behalf of the Toxicology Investigators Consortium, Steven Seifert, Adam Pomerleau, Ziad Kazzi, Michael Ganetsky, Michele Burns, Michael Beuhler, Joshua D. King, Steven Aks, Jakub Furmaga, Paul Wax, Jeffrey Brent, Christopher HoyteJerrold Leikin, Rais Vohra, Bryan Judge, Brad Riley, William J. Meggs, Didi Bentur, Phil Moore, Lynn Farrugia, Spencer Greene, Daniel Rusyniak, Jennifer Lowry, Adam Algren, Brian Wolk, Michael Levine, Josh Nogar, Mark Kostic, David Gummin, Diane Calello, Ann Jeannette Geib, Stephanie Hernandez, Silas Smith, Lewis Nelson, Steven Marcus, Ronald Kirschner, Adam Rowden, David Vearrier, Rita McKeever, Michelle Ruha, Anthony Pizon, Robert Hendrickson, Nate McKeown, Brandon Wills, Kirk Cumpston, Mohammed Alhelail, Timothy Wiegand, E. Martin Caravati, Daniel Sessions, Joseph Maddry, Alicia Minns, Derrick Lung, Craig Smollin, Thomas Kibby, Evan Schwarz, Samuel Stellpflug, Kristin Engebretsen, Nima Majlesi, Ross Sullivan, Tamas Peredy, Yaron Finkelstiein, Jennifer Carey

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The American College of Medical Toxicology established the Toxicology Investigators Consortium (ToxIC) Case Registry in 2010. The Registry contains all medical toxicology consultations performed at participating sites. The Registry has continued to grow since its inception, and as of December 31, 2015, contains 43,099 cases. This is the sixth annual report of the ToxIC Registry, summarizing the additional 8115 cases entered in 2015. Cases were identified by a query of the Registry for all cases entered between January 1 and December 31, 2015. Specific data reviewed for analysis included demographics (age, race, gender), source of consultation, reason for consultation, agents and agent classes involved in exposures, signs, symptoms, clinical findings, fatalities, and treatment. By the end of 2015, there were 50 active sites, consisting of 101 separate health-care facilities; 51.2 % of cases involved females. Adults between the ages of 19 and 65 made up the majority (64.2 %) of Registry cases. Caucasian race was the most commonly reported (55.6 %); 9.6 % of cases were identified as Hispanic ethnicity. Inpatient and emergency department referrals were by far the most common referral sources (92.9 %). Intentional pharmaceutical exposures remained the most frequent reason for consultation, making up 52.3 % of cases. Of these intentional pharmaceutical exposures, 69 % represented an attempt at self-harm, and 85.6 % of these were a suicide attempt. Nonopioid analgesics, sedative-hypnotics, and antidepressant agents were the most commonly reported agent classes in 2015. Almost one-third of Registry cases involved a diagnosed toxidrome (32.8 %), with a sedative-hypnotic toxidrome being the most frequently described. Significant vital sign abnormalities were recorded in 25.3 % of cases. There were 98 fatalities reported in the Registry (1.2 %). Adverse drug reactions were reported in 4.3 % of cases. Toxicological treatment was given in 65.3 % of cases, with 33.0 % receiving specific antidotal therapy. Exposure characteristics and trends overall were similar to prior years. While treatment interventions were required in the majority of cases, fatalities were rare.

Original languageEnglish (US)
Pages (from-to)224-247
Number of pages24
JournalJournal of Medical Toxicology
Volume12
Issue number3
DOIs
StatePublished - Sep 1 2016

Fingerprint

Toxicology
Registries
Research Personnel
Referral and Consultation
Hypnotics and Sedatives
Non-Narcotic Analgesics
Pharmaceutical Preparations
Health care
Antidepressive Agents
Annual Reports
Vital Signs
Health Facilities
Therapeutics
Drug-Related Side Effects and Adverse Reactions
Hispanic Americans
Suicide
Signs and Symptoms
Hospital Emergency Service
Inpatients
Catalytic Domain

Keywords

  • Epidemiology
  • Medical toxicology
  • Overdose
  • Poisonings
  • Surveillance

ASJC Scopus subject areas

  • Health, Toxicology and Mutagenesis
  • Toxicology

Cite this

Farrugia, L. A., Rhyee, S. H., Campleman, S. L., Ruha, A. M., Weigand, T., Wax, P. M., ... Carey, J. (2016). The Toxicology Investigators Consortium Case Registry—the 2015 Experience. Journal of Medical Toxicology, 12(3), 224-247. https://doi.org/10.1007/s13181-016-0580-6

The Toxicology Investigators Consortium Case Registry—the 2015 Experience. / Farrugia, Lynn A.; Rhyee, Sean H.; Campleman, Sharan L.; Ruha, Anne Michelle; Weigand, Timothy; Wax, Paul M.; Brent, Jeffrey; On behalf of the Toxicology Investigators Consortium, behalf of the Toxicology Investigators Consortium; Seifert, Steven; Pomerleau, Adam; Kazzi, Ziad; Ganetsky, Michael; Burns, Michele; Beuhler, Michael; King, Joshua D.; Aks, Steven; Furmaga, Jakub; Wax, Paul; Brent, Jeffrey; Hoyte, Christopher; Leikin, Jerrold; Vohra, Rais; Judge, Bryan; Riley, Brad; Meggs, William J.; Bentur, Didi; Moore, Phil; Farrugia, Lynn; Greene, Spencer; Rusyniak, Daniel; Lowry, Jennifer; Algren, Adam; Wolk, Brian; Levine, Michael; Nogar, Josh; Kostic, Mark; Gummin, David; Calello, Diane; Geib, Ann Jeannette; Hernandez, Stephanie; Smith, Silas; Nelson, Lewis; Marcus, Steven; Kirschner, Ronald; Rowden, Adam; Vearrier, David; McKeever, Rita; Ruha, Michelle; Pizon, Anthony; Hendrickson, Robert; McKeown, Nate; Wills, Brandon; Cumpston, Kirk; Alhelail, Mohammed; Wiegand, Timothy; Caravati, E. Martin; Sessions, Daniel; Maddry, Joseph; Minns, Alicia; Lung, Derrick; Smollin, Craig; Kibby, Thomas; Schwarz, Evan; Stellpflug, Samuel; Engebretsen, Kristin; Majlesi, Nima; Sullivan, Ross; Peredy, Tamas; Finkelstiein, Yaron; Carey, Jennifer.

In: Journal of Medical Toxicology, Vol. 12, No. 3, 01.09.2016, p. 224-247.

Research output: Contribution to journalArticle

Farrugia, LA, Rhyee, SH, Campleman, SL, Ruha, AM, Weigand, T, Wax, PM, Brent, J, On behalf of the Toxicology Investigators Consortium, BOTTIC, Seifert, S, Pomerleau, A, Kazzi, Z, Ganetsky, M, Burns, M, Beuhler, M, King, JD, Aks, S, Furmaga, J, Wax, P, Brent, J, Hoyte, C, Leikin, J, Vohra, R, Judge, B, Riley, B, Meggs, WJ, Bentur, D, Moore, P, Farrugia, L, Greene, S, Rusyniak, D, Lowry, J, Algren, A, Wolk, B, Levine, M, Nogar, J, Kostic, M, Gummin, D, Calello, D, Geib, AJ, Hernandez, S, Smith, S, Nelson, L, Marcus, S, Kirschner, R, Rowden, A, Vearrier, D, McKeever, R, Ruha, M, Pizon, A, Hendrickson, R, McKeown, N, Wills, B, Cumpston, K, Alhelail, M, Wiegand, T, Caravati, EM, Sessions, D, Maddry, J, Minns, A, Lung, D, Smollin, C, Kibby, T, Schwarz, E, Stellpflug, S, Engebretsen, K, Majlesi, N, Sullivan, R, Peredy, T, Finkelstiein, Y & Carey, J 2016, 'The Toxicology Investigators Consortium Case Registry—the 2015 Experience', Journal of Medical Toxicology, vol. 12, no. 3, pp. 224-247. https://doi.org/10.1007/s13181-016-0580-6
Farrugia LA, Rhyee SH, Campleman SL, Ruha AM, Weigand T, Wax PM et al. The Toxicology Investigators Consortium Case Registry—the 2015 Experience. Journal of Medical Toxicology. 2016 Sep 1;12(3):224-247. https://doi.org/10.1007/s13181-016-0580-6
Farrugia, Lynn A. ; Rhyee, Sean H. ; Campleman, Sharan L. ; Ruha, Anne Michelle ; Weigand, Timothy ; Wax, Paul M. ; Brent, Jeffrey ; On behalf of the Toxicology Investigators Consortium, behalf of the Toxicology Investigators Consortium ; Seifert, Steven ; Pomerleau, Adam ; Kazzi, Ziad ; Ganetsky, Michael ; Burns, Michele ; Beuhler, Michael ; King, Joshua D. ; Aks, Steven ; Furmaga, Jakub ; Wax, Paul ; Brent, Jeffrey ; Hoyte, Christopher ; Leikin, Jerrold ; Vohra, Rais ; Judge, Bryan ; Riley, Brad ; Meggs, William J. ; Bentur, Didi ; Moore, Phil ; Farrugia, Lynn ; Greene, Spencer ; Rusyniak, Daniel ; Lowry, Jennifer ; Algren, Adam ; Wolk, Brian ; Levine, Michael ; Nogar, Josh ; Kostic, Mark ; Gummin, David ; Calello, Diane ; Geib, Ann Jeannette ; Hernandez, Stephanie ; Smith, Silas ; Nelson, Lewis ; Marcus, Steven ; Kirschner, Ronald ; Rowden, Adam ; Vearrier, David ; McKeever, Rita ; Ruha, Michelle ; Pizon, Anthony ; Hendrickson, Robert ; McKeown, Nate ; Wills, Brandon ; Cumpston, Kirk ; Alhelail, Mohammed ; Wiegand, Timothy ; Caravati, E. Martin ; Sessions, Daniel ; Maddry, Joseph ; Minns, Alicia ; Lung, Derrick ; Smollin, Craig ; Kibby, Thomas ; Schwarz, Evan ; Stellpflug, Samuel ; Engebretsen, Kristin ; Majlesi, Nima ; Sullivan, Ross ; Peredy, Tamas ; Finkelstiein, Yaron ; Carey, Jennifer. / The Toxicology Investigators Consortium Case Registry—the 2015 Experience. In: Journal of Medical Toxicology. 2016 ; Vol. 12, No. 3. pp. 224-247.
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abstract = "The American College of Medical Toxicology established the Toxicology Investigators Consortium (ToxIC) Case Registry in 2010. The Registry contains all medical toxicology consultations performed at participating sites. The Registry has continued to grow since its inception, and as of December 31, 2015, contains 43,099 cases. This is the sixth annual report of the ToxIC Registry, summarizing the additional 8115 cases entered in 2015. Cases were identified by a query of the Registry for all cases entered between January 1 and December 31, 2015. Specific data reviewed for analysis included demographics (age, race, gender), source of consultation, reason for consultation, agents and agent classes involved in exposures, signs, symptoms, clinical findings, fatalities, and treatment. By the end of 2015, there were 50 active sites, consisting of 101 separate health-care facilities; 51.2 {\%} of cases involved females. Adults between the ages of 19 and 65 made up the majority (64.2 {\%}) of Registry cases. Caucasian race was the most commonly reported (55.6 {\%}); 9.6 {\%} of cases were identified as Hispanic ethnicity. Inpatient and emergency department referrals were by far the most common referral sources (92.9 {\%}). Intentional pharmaceutical exposures remained the most frequent reason for consultation, making up 52.3 {\%} of cases. Of these intentional pharmaceutical exposures, 69 {\%} represented an attempt at self-harm, and 85.6 {\%} of these were a suicide attempt. Nonopioid analgesics, sedative-hypnotics, and antidepressant agents were the most commonly reported agent classes in 2015. Almost one-third of Registry cases involved a diagnosed toxidrome (32.8 {\%}), with a sedative-hypnotic toxidrome being the most frequently described. Significant vital sign abnormalities were recorded in 25.3 {\%} of cases. There were 98 fatalities reported in the Registry (1.2 {\%}). Adverse drug reactions were reported in 4.3 {\%} of cases. Toxicological treatment was given in 65.3 {\%} of cases, with 33.0 {\%} receiving specific antidotal therapy. Exposure characteristics and trends overall were similar to prior years. While treatment interventions were required in the majority of cases, fatalities were rare.",
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AU - Wax, Paul M.

AU - Brent, Jeffrey

AU - On behalf of the Toxicology Investigators Consortium, behalf of the Toxicology Investigators Consortium

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AU - Geib, Ann Jeannette

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AU - Caravati, E. Martin

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AU - Maddry, Joseph

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AU - Stellpflug, Samuel

AU - Engebretsen, Kristin

AU - Majlesi, Nima

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AU - Finkelstiein, Yaron

AU - Carey, Jennifer

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N2 - The American College of Medical Toxicology established the Toxicology Investigators Consortium (ToxIC) Case Registry in 2010. The Registry contains all medical toxicology consultations performed at participating sites. The Registry has continued to grow since its inception, and as of December 31, 2015, contains 43,099 cases. This is the sixth annual report of the ToxIC Registry, summarizing the additional 8115 cases entered in 2015. Cases were identified by a query of the Registry for all cases entered between January 1 and December 31, 2015. Specific data reviewed for analysis included demographics (age, race, gender), source of consultation, reason for consultation, agents and agent classes involved in exposures, signs, symptoms, clinical findings, fatalities, and treatment. By the end of 2015, there were 50 active sites, consisting of 101 separate health-care facilities; 51.2 % of cases involved females. Adults between the ages of 19 and 65 made up the majority (64.2 %) of Registry cases. Caucasian race was the most commonly reported (55.6 %); 9.6 % of cases were identified as Hispanic ethnicity. Inpatient and emergency department referrals were by far the most common referral sources (92.9 %). Intentional pharmaceutical exposures remained the most frequent reason for consultation, making up 52.3 % of cases. Of these intentional pharmaceutical exposures, 69 % represented an attempt at self-harm, and 85.6 % of these were a suicide attempt. Nonopioid analgesics, sedative-hypnotics, and antidepressant agents were the most commonly reported agent classes in 2015. Almost one-third of Registry cases involved a diagnosed toxidrome (32.8 %), with a sedative-hypnotic toxidrome being the most frequently described. Significant vital sign abnormalities were recorded in 25.3 % of cases. There were 98 fatalities reported in the Registry (1.2 %). Adverse drug reactions were reported in 4.3 % of cases. Toxicological treatment was given in 65.3 % of cases, with 33.0 % receiving specific antidotal therapy. Exposure characteristics and trends overall were similar to prior years. While treatment interventions were required in the majority of cases, fatalities were rare.

AB - The American College of Medical Toxicology established the Toxicology Investigators Consortium (ToxIC) Case Registry in 2010. The Registry contains all medical toxicology consultations performed at participating sites. The Registry has continued to grow since its inception, and as of December 31, 2015, contains 43,099 cases. This is the sixth annual report of the ToxIC Registry, summarizing the additional 8115 cases entered in 2015. Cases were identified by a query of the Registry for all cases entered between January 1 and December 31, 2015. Specific data reviewed for analysis included demographics (age, race, gender), source of consultation, reason for consultation, agents and agent classes involved in exposures, signs, symptoms, clinical findings, fatalities, and treatment. By the end of 2015, there were 50 active sites, consisting of 101 separate health-care facilities; 51.2 % of cases involved females. Adults between the ages of 19 and 65 made up the majority (64.2 %) of Registry cases. Caucasian race was the most commonly reported (55.6 %); 9.6 % of cases were identified as Hispanic ethnicity. Inpatient and emergency department referrals were by far the most common referral sources (92.9 %). Intentional pharmaceutical exposures remained the most frequent reason for consultation, making up 52.3 % of cases. Of these intentional pharmaceutical exposures, 69 % represented an attempt at self-harm, and 85.6 % of these were a suicide attempt. Nonopioid analgesics, sedative-hypnotics, and antidepressant agents were the most commonly reported agent classes in 2015. Almost one-third of Registry cases involved a diagnosed toxidrome (32.8 %), with a sedative-hypnotic toxidrome being the most frequently described. Significant vital sign abnormalities were recorded in 25.3 % of cases. There were 98 fatalities reported in the Registry (1.2 %). Adverse drug reactions were reported in 4.3 % of cases. Toxicological treatment was given in 65.3 % of cases, with 33.0 % receiving specific antidotal therapy. Exposure characteristics and trends overall were similar to prior years. While treatment interventions were required in the majority of cases, fatalities were rare.

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