Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Int J Inj Contr Saf Promot. 2009 Dec;16(4):223-30. doi: 10.1080/17457300903307094.
Cleistanthus collinus (local name: oduvan) poisoning is a common suicidal poisoning method used in rural southern India. There are few studies on this issue and they have small sample sizes. This study examines the epidemiology of oduvan poisoning in a large sample, highlighting socio-demographic and clinical profile, complications, and risk factors for mortality. This study is a retrospective case series of 127 oduvan intentionally poisoned patients presenting at a tertiary care teaching hospital between the years 1990-1999. Descriptive statistics, cumulative case fatality rates and time to death from ingestion of poison were calculated. Cox regression adjusting for left truncation was used to investigate the effects of covariates on death. Patients' average (sd) age was 29.1 (10.9), 62% were female, 76% were married and 49% were housewives. The cumulative case fatality rate was 30%. The median time to death after oduvan ingestion was 3 days. Common signs and symptoms included hypokalaemia, vomiting, hyponatraemia, altered sensorium, bradycardia and abnormal ECG. There was a 58% risk reduction (95% CI: 29-75) in death with each 1 mmol/l increase in plasma potassium level. Patient's age was associated with an increased risk of death and the estimated hazard ratio for an increase of 10 years in age was 1.56 (95% CI: 1.18-2.07). Use of boiled oduvan extract was associated with an increased mortality (HR: 2.71, 95% CI: 1.17-6.32) compared to ingesting fresh leaves. Risk factors for oduvan poisoning mortality were hypokalaemia, older age, mode of consumption and an elevated risk for death with presence of chronic disease. When consumed as a boiled extract, oduvan is more lethal. We recommend close monitoring, correction of plasma potassium and appropriate supportive measures.
克莱斯坦斯·科利努斯（当地名称：奥杜万）中毒是印度南部农村地区常见的自杀性中毒方法。关于这个问题的研究很少，而且样本量很小。本研究通过大样本研究了奥杜万中毒的流行病学，重点介绍了社会人口学和临床特征、并发症以及死亡率的危险因素。这是一项对 1990-1999 年间在一家三级护理教学医院就诊的 127 例奥杜万故意中毒患者的回顾性病例系列研究。计算了描述性统计、累积病死率和从摄入毒物到死亡的时间。使用 Cox 回归调整左截断来研究协变量对死亡的影响。患者的平均（标准差）年龄为 29.1（10.9），62%为女性，76%已婚，49%为家庭主妇。累积病死率为 30%。奥杜万中毒后死亡的中位数时间为 3 天。常见的体征和症状包括低钾血症、呕吐、低钠血症、意识改变、心动过缓和异常心电图。血浆钾水平每增加 1mmol/l，死亡风险降低 58%（95%CI：29-75）。患者年龄与死亡风险增加相关，年龄每增加 10 岁，估计的危险比为 1.56（95%CI：1.18-2.07）。与服用新鲜叶片相比，服用煮沸的奥杜万提取物与死亡率增加相关（HR：2.71，95%CI：1.17-6.32）。奥杜万中毒死亡的危险因素包括低钾血症、年龄较大、摄入方式以及存在慢性疾病时死亡风险增加。当作为煮沸提取物服用时，奥杜万更致命。我们建议密切监测、纠正血浆钾和适当的支持措施。
