Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Pediatr Neonatol. 2011 Feb;52(1):11-7. doi: 10.1016/j.pedneo.2010.12.003. Epub 2011 Feb 22.
Pharmaceuticals involved in childhood poisoning vary, and treatment of poison exposure can be a challenge for primary physicians when children are unconscious or histories are lacking. Knowledge of the clinical manifestations and prognosis of poisoning will help primary physicians perform appropriate clinical assessments. In this study, we aim to report on patient characteristics, outcomes, and clinical features of pediatric poisoning in the emergency department.
We retrospectively evaluated the medical records of 87 children younger than 18 years of age and presented to the emergency department with pharmaceutical poisoning (2001-2008). The detailed categories of pharmaceutical were reported, and their associations with patient outcomes were analyzed. Furthermore, children were divided into two groups, based on the reasons for poison exposure (accidental or intentional poisoning). Clinical features and outcomes between accidental or intentional poisoning were analyzed, and the cut-off age for high risk of intentional poisoning was also calculated.
Age groups of adolescents (48.3%) and preschool age (32.2%) children were the major representation. Neurologic system agents (48.3%) and analgesics (18.4%) were the most common causes of poisoning. Among the two major agents above, anxiolytic/hypnotic drugs (lorazepam) and acetaminophen were the most frequent causes. Of all children, 70.1% had duration of major symptoms for ≤1 day, and intentional poisoning caused significantly longer duration of hospital stay than accidental poisoning did (p=0.008). Moreover, female gender (p<0.001), older age (p<0.001), and analgesics (p=0.008) were more predominantly associated with intentional poisoning in children, and the cut-off age for high risk of intentional poisoning was over 10.5 years.
Neurologic system agents and analgesics were responsible for the majority of cases. Intentional poisoning caused longer hospital length of stay than accidental poisoning, and the factors associated with intentional poisoning were older age, female, and neurologic system agents.
儿童中毒所涉及的药物各不相同，当儿童处于昏迷状态或无法提供病史时，初级医师对药物暴露的治疗可能具有挑战性。了解中毒的临床表现和预后将有助于初级医师进行适当的临床评估。在这项研究中，我们旨在报告急诊科儿科中毒患者的特征、结局和临床特征。
我们回顾性评估了 2001 年至 2008 年期间因药物中毒就诊于急诊科的 87 名年龄小于 18 岁的儿童的病历。报告了药物的详细类别，并分析了它们与患者结局的关系。此外，根据中毒原因（意外或故意中毒）将儿童分为两组。分析意外或故意中毒的临床特征和结局，并计算故意中毒高风险的截止年龄。
青少年（48.3%）和学龄前儿童（32.2%）是主要人群。神经系统药物（48.3%）和镇痛药（18.4%）是最常见的中毒原因。在上述两种主要药物中，最常见的原因是镇静/催眠药（劳拉西泮）和对乙酰氨基酚。在所有儿童中，70.1%的主要症状持续时间≤1 天，故意中毒导致的住院时间明显长于意外中毒（p=0.008）。此外，女性（p<0.001）、年龄较大（p<0.001）和镇痛药（p=0.008）与儿童故意中毒的关系更密切，故意中毒的高风险截止年龄超过 10.5 岁。
神经系统药物和镇痛药是大多数中毒的原因。故意中毒导致的住院时间长于意外中毒，与故意中毒相关的因素是年龄较大、女性和神经系统药物。
