Pediatr Emerg Care. 2021 Dec 1;37(12):e1631-e1636. doi: 10.1097/PEC.0000000000002141.
Suicide is a growing public health problem during late childhood and adolescence. The leading method of suicide attempts in this age group is intentional self-poisoning. A first self-poisoning episode is a strong predictor of subsequent suicide and premature death. The objective of this study was to analyze the presentation and management of children younger than 18 years with intentional self-poisonings admitted to an emergency department (ED) in a global research network of pediatric EDs.
We performed a secondary analysis of a large, international, multicenter, cross-sectional prospective registry of childhood poisoning presentations to 105 EDs in the Pediatric Emergency Research Networks (PERN) network. Data collection started at each ED between January and September 2013 and continued for 1 year.
During the study period, we included 1688 poisoning exposures. Of these, 233 (13.8%) were intentional self-poisonings, with significant variation between regions. Female/male ratio was 4.7/1 and most occurred at home. The most common toxicants were therapeutic drugs, mainly psychotropics and analgesics. Ninety patients (38.6%) gave a history of a previous episode of intentional self-poisoning. Sixty-three children (27.0%) were not assessed by a psychiatric service nor transferred to a psychiatric inpatient facility. No patient died. There was significant variation in the involved toxicants and interventions among EDs in different global regions.
Most intentional self-poisoning presentations to pediatric EDs globally are related to intentional ingestions of therapeutic drugs at home by females. Best practices have to be translated into care to guarantee the best outcomes of these patients.
自杀是儿童晚期和青少年时期日益严重的公共卫生问题。该年龄段自杀企图的主要方法是故意自我中毒。首次自我中毒是随后自杀和过早死亡的强烈预测指标。本研究的目的是分析在全球儿科急诊研究网络的一个急诊部门（ED）中，18 岁以下故意自我中毒的儿童的表现和管理。
我们对儿科急诊研究网络（PERN）网络中 105 个急诊部门进行的一项大型、国际、多中心、横断面前瞻性儿童中毒报告的二次分析。数据收集从每个急诊部门的 2013 年 1 月至 9 月开始，并持续了 1 年。
在研究期间，我们共纳入 1688 例中毒暴露病例。其中，233 例（13.8%）为故意自我中毒，不同地区差异显著。女性/男性比例为 4.7/1，大多数发生在家庭中。最常见的毒物是治疗药物，主要是精神药物和镇痛药。90 名患者（38.6%）有过以前故意自我中毒的病史。63 名儿童（27.0%）未接受精神科评估或转至精神科住院治疗。没有患者死亡。不同全球地区的急诊部门涉及的毒物和干预措施存在显著差异。
全球大多数儿科急诊部门的故意自我中毒报告都与女性在家中故意摄入治疗药物有关。必须将最佳实践转化为护理，以保证这些患者的最佳结果。
