Enfield Ben, Brooks Daniel E, Welch Sharyn, Roland Maureen, Klemens Jane, Greenlief Kim, Olson Rachel, Gerkin Richard D
University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
Banner Poison and Drug Information Center, Phoenix, AZ, USA.
J Med Toxicol. 2018 Mar;14(1):74-78. doi: 10.1007/s13181-017-0643-3. Epub 2018 Jan 12.
There is little published data about human plant exposures reported to US poison control centers (PCCs).
A retrospective chart review of all reported plant exposures to a single regional PCC between January 1, 2003 and December 31, 2010 was done to understand better the characteristics of plant exposure cases. Specific generic plant codes were used to identify cases. Recorded variables included patient demographics, plant involved, exposure variables, symptoms, management site, treatments, and outcome. Univariate and multivariate regression was used to identify outcome predictors.
A total of 6492 charts met inclusion criteria. The average age was 16.6 years (2 months-94 years); 52.4% were male. The most common exposure reason was unintentional (98%), and the majority (92.4%) occurred at the patient's home. Ingestions (58.3%) and dermal exposures (34.3%) accounted for most cases. Cactus (27.5%), oleander (12.5%), Lantana (5.7%), and Bougainvillea (3.8%) were most commonly involved. Symptoms developed in 47.1% of patients, and were more likely to occur following Datura (66.7%), and Morning Glory or Milkweed (25% each) exposures. Almost 94% of patients were managed onsite (home) and only 5.2% involved evaluation in a health care facility (HCF). Only 37 (0.6%) patients required hospital admission, and 2.9% of cases resulted in more than minimal effects. Exposures resulting in more than minimal clinical effects were predicted by several variables: abnormal vital signs (OR = 35.62), abnormal labs (OR = 14.87), and management at a HCF (OR = 7.37). Hospital admissions were increased for patients already at a HCF (OR = 54.01), abnormal vital signs (OR = 23.28), and intentional exposures (OR = 14.7).
Plant exposures reported to our poison control center were typically unintentional ingestions occurring at home. Most patients were managed onsite and few developed significant symptoms.
向美国毒物控制中心(PCCs)报告的人类植物暴露情况的公开数据很少。
对2003年1月1日至2010年12月31日期间向单个地区毒物控制中心报告的所有植物暴露情况进行回顾性图表审查,以更好地了解植物暴露病例的特征。使用特定的通用植物代码来识别病例。记录的变量包括患者人口统计学信息、所涉及的植物、暴露变量、症状、处理地点、治疗方法和结果。采用单变量和多变量回归来确定结果预测因素。
共有6492份图表符合纳入标准。平均年龄为16.6岁(2个月至94岁);52.4%为男性。最常见的暴露原因是无意暴露(98%),大多数(92.4%)发生在患者家中。摄入(58.3%)和皮肤暴露(34.3%)占大多数病例。仙人掌(27.5%)、夹竹桃(12.5%)、马缨丹(5.7%)和九重葛(3.8%)是最常涉及的植物。47.1%的患者出现了症状,在接触曼陀罗(66.7%)、牵牛花或马利筋(各25%)后更易出现症状。几乎94%的患者在现场(家中)接受处理,只有5.2%的患者在医疗保健机构(HCF)接受评估。只有37例(0.6%)患者需要住院治疗,2.9%的病例产生了超过轻微程度的影响。几个变量可预测导致超过轻微临床影响的暴露情况:生命体征异常(OR = 35.62)、实验室检查异常(OR = 14.87)以及在医疗保健机构接受处理(OR = 7.37)。已在医疗保健机构的患者住院率增加(OR = 54.01)、生命体征异常(OR = 23.28)以及故意暴露(OR = 14.7)。
向我们毒物控制中心报告的植物暴露情况通常是在家中发生的无意摄入。大多数患者在现场接受处理,很少有患者出现严重症状。