Mathew Roshan, Jamshed Nayer, Aggarwal Praveen, Patel Shivam, Pandey R M
Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
J Family Med Prim Care. 2019 Dec 10;8(12):3935-3939. doi: 10.4103/jfmpc.jfmpc_832_19. eCollection 2019 Dec.
Aim of this study was to characterize acute poisoning and snakebite cases and their outcome in the Emergency Department (ED).
This was a prospective study done in the ED of a tertiary healthcare center. Study included 184 patients of acute poisoning and 16 cases of snakebite. Data regarding demographics, type, time, and mode of poisoning, lag time in reaching the hospital, initiation of treatment, first aid, in-hospital treatment, and comorbid illness were obtained. Data regarding requirement of antidote, duration of hospitalization, and outcome were also obtained.
Out of 200 cases, 181 (90.5%) were adults and 19 (9.5%) were of pediatric age group. Poisoning was common among males (57%) than females (43%). Majority (40%) were from the age group of 21-30 years. Out of 200, 115 (57.5%) poisonings were suicidal, 68 (34%) were accidental, and 17 (8.5%) were homicidal. Acute poisonings included corrosive 54 (27%), drug overdose 26 (13%), organophosphorus compounds 20 (10%), rodenticides 20 (10%), and symptomatic snakebite 16 (8%). Seventy-two (36%) were admitted with a median hospital stay of 6 days with 5 (2.5%) deaths. Logistic regression analysis revealed poorer outcome for 15-30 years age [OR 12.6 (1.6-97.5), = 0.015], males [OR 2.5 (1.4-4.4) = 0.04], patients coming from >30 km [OR 4.3 (1.5-12.1), = 0.006].
Our study demonstrated an increased incidence of corrosive ingestion. With increasing rates of suicidal ingestions, there is a need for holistic approach to manage mental health issues at primary care level.
本研究旨在描述急诊科急性中毒和蛇咬伤病例及其结局。
这是在一家三级医疗中心急诊科进行的一项前瞻性研究。研究纳入了184例急性中毒患者和16例蛇咬伤患者。获取了有关人口统计学、中毒类型、时间和方式、到达医院的延迟时间、治疗开始情况、急救、住院治疗以及合并症的数据。还获取了有关解毒剂需求、住院时间和结局的数据。
在200例病例中，181例（90.5%）为成年人，19例（9.5%）为儿童年龄组。中毒在男性中（57%）比女性中（43%）更常见。大多数（40%）来自21至30岁年龄组。在200例中，115例（57.5%）中毒为自杀性，68例（34%）为意外，17例（8.5%）为他杀。急性中毒包括腐蚀性中毒54例（27%）、药物过量26例（13%）、有机磷化合物中毒20例（10%）、杀鼠剂中毒20例（10%）以及有症状的蛇咬伤16例（8%）。72例（36%）患者入院，中位住院时间为6天，5例（2.5%）死亡。逻辑回归分析显示，15至30岁年龄组[比值比12.6（1.6 - 97.5），P = 0.015]、男性[比值比2.5（1.4 - 4.4），P = 0.04]、来自距离大于30公里处的患者[比值比4.3（1.5 - 12.1），P = 0.006]的结局较差。
我们的研究表明腐蚀性摄入的发生率增加。随着自杀性摄入率的上升，在初级保健层面需要采取整体方法来管理心理健康问题。
