Świderska Aleksandra, Wiśniewski Marek, Wiergowski Marek, Krakowiak Anna, Sein Anand Jacek
National Health Fund Headquarters, Warsaw, Poland.
Department of Clinical Toxicology, Medical University of Gdansk, Kartuska 4/6, 80-104, Gdansk, Poland.
BMC Pharmacol Toxicol. 2018 Oct 10;19(1):62. doi: 10.1186/s40360-018-0254-x.
Poisonings constitute a significant medical, social and economic problem worldwide. In Poland there is no nationwide registry of poisonings, which results in a lack of accurate epidemiological data. Few publications dealing with the problem are based on data obtained from toxicology units and therefore do not include information about cases treated at emergency departments and other non-toxicology units.
We analyzed all admissions due to poisonings reported to the Polish National Health Fund by all hospital units in Poland in the 2009-2011 period. Diagnoses were encoded according to the ICD-10 classification.
A total of 254,425 admissions were reported, 85,398 in 2009, 85,230 in 2010 and 83,797 in 2011. The male to female ratios were 1.88, 1.75 and 1.80 respectively. The most frequent causes of admissions were poisonings with ethanol (n = 121,874; 47.9%), carbon monoxide (n = 17,179; 6.8%) and benzodiazepines (n = 10,340; 4.1%). Alcohols were the reason for 104,680 admissions in men (63.2%) and 22,612 admissions in women (25.5%; p < 0.01). Poisonings with pharmaceuticals and other drugs were reported in 34,616 men (20.9%) and 45,238 women (51%; p < 0.01). There were 1680 cases of fatal poisonings in the analyzed period. The hospital mortality due to poisonings increased from 1.1% in 2009 to 1.5% in 2011 (p < 0.01). The mortality in general Intensive Care Units increased from 14.4% in 2009 to 22.3% in 2011 (p < 0.01). The etiology of fatal poisonings was highly dependent on the type of hospital unit.
The overall number of admissions due to poisonings decreased slightly during the study period, but they remained a significant cause of morbidity and mortality. Alcohols were the main cause of admissions in the analyzed period. Alcohol intoxications were more frequent in men while poisonings with pharmaceuticals were more frequent in women. Carbon monoxide exposures were a significant cause of morbidity and mortality in the studied period in Poland. A national poison information and toxicovigilance system should be created in Poland, ideally allowing for near real-time monitoring of cases of poisonings.
中毒在全球范围内构成了一个重大的医学、社会和经济问题。在波兰，没有全国性的中毒登记系统，这导致缺乏准确的流行病学数据。很少有关于该问题的出版物是基于从毒理学单位获得的数据，因此不包括在急诊科和其他非毒理学单位治疗的病例信息。
我们分析了2009 - 2011年期间波兰所有医院单位向波兰国家卫生基金报告的所有中毒入院病例。诊断根据ICD - 10分类进行编码。
共报告了254,425例入院病例，2009年为85,398例，2010年为85,230例，2011年为83,797例。男女比例分别为1.88、1.75和1.80。入院的最常见原因是乙醇中毒（n = 121,874；47.9%）、一氧化碳中毒（n = 17,179；6.8%）和苯二氮䓬类中毒（n = 10,340；4.1%）。酒精是男性104,680例入院（63.2%）和女性22,612例入院（25.5%；p < 0.01）的原因。药物和其他药物中毒在男性中有34,616例报告（20.9%），在女性中有45,238例报告（51%；p < 0.01）。在分析期间有1680例致命中毒病例。中毒导致的医院死亡率从2009年的1.1%上升到2011年的1.5%（p < 0.01）。普通重症监护病房的死亡率从2009年的14.4%上升到2011年的22.3%（p < 0.01）。致命中毒的病因高度依赖于医院单位的类型。
在研究期间，中毒入院的总数略有下降，但它们仍然是发病和死亡的重要原因。酒精是分析期间入院的主要原因。酒精中毒在男性中更常见，而药物中毒在女性中更常见。一氧化碳暴露是波兰研究期间发病和死亡的一个重要原因。波兰应建立一个国家中毒信息和毒理学监测系统，理想情况下允许对中毒病例进行近实时监测。
