Le Vaillant J, Pellerin L, Brouard J, Nimal-Cuvillon D
Service de pédiatrie médicale, CHU Caen, avenue de la Côte-de-Nacre, 14033 Caen, France.
Service de pédiatrie médicale, CHU Caen, avenue de la Côte-de-Nacre, 14033 Caen, France.
Arch Pediatr. 2016 May;23(5):461-7. doi: 10.1016/j.arcped.2016.02.009. Epub 2016 Mar 23.
Biological complications in adolescents' self-poisoning are not currently evaluated. The aim of this study was to describe the toxicological characteristics of suicide attempts, the ingested substances, and their complications to better prevent the risks associated with deliberate self-poisoning.
This was a descriptive, prospective, single-center study. It took place in the pediatric emergency, hospitalization, and intensive care unit of the Caen University Hospital. All children aged 10-18years who had presented to the pediatric emergency department between 1 June 2012 and 1 June 2013 for deliberate self-poisoning were included. Somatic evaluation was conducted for the protocol on arrival at the emergency room, and repeated during hospitalization, and biological evaluation was performed on arrival at the pediatric emergency unit and on the 5th day after the drug intoxication. A questionnaire was completed at this time to identify the substances ingested and the risk factors for suicide attempt.
Acetaminophen was the most frequently chosen substance compared to other drugs in acute drug overdose (P=0.01). Abdominal pain on arrival at the emergency room were significantly associated with acetaminophen (P=0.02). In 10% of the cases, a transfer to the pediatric intensive care unit was required. In total, 3.4% had acute renal failure and 3.4% acute liver failure in connection with acetaminophen ingestion. Biological complications and symptoms disappeared prior to hospital discharge. The average hospital stay was 7.1 days.
This study focused on biological complications in pediatric emergencies, but also later on deliberate self-poisoning to detect other complications. It seems important to detect the presence of liver or kidney failure, and more importantly whether there is acetaminophen ingestion. The prevention of suicide attempt recurrences also remains a priority, given the increased risk of mortality from repeating a suicide attempt. Systematization of biological assessments made in emergency situations but particularly in the hospital could improve the care of these adolescents.
目前尚未对青少年自我中毒的生物学并发症进行评估。本研究的目的是描述自杀未遂的毒理学特征、摄入的物质及其并发症，以便更好地预防与蓄意自我中毒相关的风险。
这是一项描述性、前瞻性、单中心研究。研究在卡昂大学医院的儿科急诊科、住院部和重症监护室进行。纳入了2012年6月1日至2013年6月1日期间因蓄意自我中毒到儿科急诊科就诊的所有10至18岁儿童。在到达急诊室时按照方案进行躯体评估，并在住院期间重复进行，同时在到达儿科急诊单元时以及药物中毒后第5天进行生物学评估。此时完成一份问卷以确定摄入的物质和自杀未遂的风险因素。
与其他药物相比，对乙酰氨基酚是急性药物过量时最常选择的物质（P = 0.01）。到达急诊室时的腹痛与对乙酰氨基酚显著相关（P = 0.02）。10%的病例需要转至儿科重症监护室。总共3.4%的患者因摄入对乙酰氨基酚出现急性肾衰竭，3.4%出现急性肝衰竭。生物学并发症和症状在出院前消失。平均住院时间为7.1天。
本研究关注儿科急诊中的生物学并发症，以及后来蓄意自我中毒的情况以检测其他并发症。检测肝或肾衰竭的存在似乎很重要，更重要的是是否摄入了对乙酰氨基酚。鉴于重复自杀未遂会增加死亡风险，预防自杀未遂复发也仍然是一个优先事项。在紧急情况下，尤其是在医院进行生物学评估的系统化可以改善对这些青少年的护理。
