University of Oulu

Koskela et al. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2017) 25:48 DOI 10.1186/s13049-017-0391-z

Do pre-hospital poisoning deaths differ from in-hospital deaths? : a retrospective analysis

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Author: Koskela, Lauri1,2; Raatiniemi, Lasse2,3; Bakke, Håkon Kvåle4,5;
Organizations: 1Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital
2Medical Research Center, Study Group of Surgery, Anesthesiology and Intensive Care, Oulu University
3Centre for Pre-Hospital Emergency Care, Oulu University Hospital
4Anesthesia and Critical Care Research Group, University of Tromsø
5Mo i Rana Hospital, Helgeland Hospital Trust
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link:
Language: English
Published: Springer Nature, 2017
Publish Date: 2017-06-28


Background: Most fatal poisonings occur outside the hospital and the victims found dead. The purpose of this study was to determine the general pattern and patient demographics of fatal poisonings in Northern Finland. In particular, we wanted to analyze differences between pre-hospital and in-hospital deaths.

Methods: All fatal poisonings that occurred in Northern Finland in 2007–2011 were retrieved from the Cause of Death Registry provided by Statistics Finland. We noted the patient demographics, causal agents, and other characteristics of the poisoning events.

Results: A total of 689 fatal poisonings occurred during the study period, of which only 42 (6.1%) reached the hospital alive. Those who died pre-hospital were significantly younger (50 vs. 56 years, p = 0.04) and more likely to be male (77% vs. 57%, p = 0.003). Cardiopulmonary resuscitation was attempted less often in pre-hospital cases (9.9% vs. 47.6%, p < 0.001). Ethanol was more frequently the main toxic agent in pre-hospital deaths (58.4% vs. 26.2%, p < 0.001), and multiple ingestions were more common (52.2% vs. 35.7%, p < 0.001) in pre-hospital deaths.

Discussion: Most of the pre-hospital fatal poisoning victims are found dead and the majority of in-hospital victims are admitted to hospital in an already serious condition. According to results of this and former studies, prevention seems to be the most important factor in reducing deaths due to poisoning.

Conclusions: The majority of poisoning-related deaths occur pre-hospital and are related to alcohol intoxication and multiple ingestions.

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Series: Scandinavian journal of trauma, resuscitation and emergency medicine
ISSN: 1757-7241
ISSN-E: 1757-7241
ISSN-L: 1757-7241
Volume: 25
Article number: 48
DOI: 10.1186/s13049-017-0391-z
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: The study was funded by grants from Oulu University Hospital and North Finland Support Foundation for Health Care
Copyright information: © The Author(s). 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.