Chatterjee Suparna, Verma Vivek Kumar, Hazra Avijit, Pal Jyotirmoy
Department of Pharmacology, IPGMER, Kolkata, West Bengal, India.
Department of General Medicine, IPGMER, Kolkata, West Bengal, India.
Perspect Clin Res. 2020 Apr-Jun;11(2):75-80. doi: 10.4103/picr.PICR_181_18. Epub 2020 May 6.
Poisoning is a preventable cause of morbidity and mortality in India. We undertook a prospective observational study to estimate the incidence, nature, severity and treatment outcome trends of acute poisoning in a tertiary care hospital in eastern India.
All patients, admitted during the study period with acute poisoning, drug overdose and envenomation, were enrolled. Food poisonings, animal bites, chronic drug or chemical poisonings were excluded. Medical records were scrutinized and caregiver interviews served as source documents. Demographics, nature and circumstances of the poisoning event, treatment offered, duration of hospitalization and outcome data were collected.
Over 18 months, 592 cases of acute poisoning, accounting for 0.63% of all hospital admissions, were enrolled. Males comprised 57.09%, median age was 22 years, and 52.20% hailed from rural area. Occupation-wise, excluding students and children, patients were mostly daily wage workers followed by housewives, service holders and farm workers. Snake bites comprised the largest category of cases at 264 (44.6%) followed by corrosives (13.68%), sedatives/hypnotics (13.18%), pesticides (12.16%), hydrocarbon oils (8.61%) and others. Majority (60.64%) of the cases was accidental and occurred at home (66.72%) and most (87.33%) were referred from primary health centers. Median time between event and arrival at primary care center was 1 hour while median time to arrival at the hospital was 11 hours. There were 89 deaths (mortality 15.03%) in the series. Male gender, rural residence, referred status and non-use of specific antidotes had negative impact on survival.
This large prospective study from eastern India from a hospital perspective, has captured data not only on the incidence and nature of poisoning but also on treatment trends and mortality outcomes. Field studies conducted in the light of these results will clarify additional issues.
在印度，中毒是发病率和死亡率的一个可预防原因。我们开展了一项前瞻性观察性研究，以估计印度东部一家三级护理医院急性中毒的发病率、性质、严重程度及治疗结果趋势。
纳入研究期间因急性中毒、药物过量及中毒而入院的所有患者。排除食物中毒、动物咬伤、慢性药物或化学中毒。仔细审查病历，并将护理人员访谈作为原始文件。收集人口统计学资料、中毒事件的性质和情况、所提供的治疗、住院时间及结果数据。
在18个月期间，纳入了592例急性中毒病例，占所有住院患者的0.63%。男性占57.09%，中位年龄为22岁，52.20%来自农村地区。按职业划分，排除学生和儿童后，患者大多为日薪工人，其次是家庭主妇、服务业从业者和农场工人。蛇咬伤病例最多，为264例（44.6%），其次是腐蚀性物质中毒（13.68%）、镇静剂/催眠药中毒（13.18%）、农药中毒（12.16%）、烃油中毒（8.61%）及其他。大多数病例（60.64%）为意外中毒，且发生在家中（66.72%），大多数（87.33%）是从初级卫生中心转诊而来。事件发生至抵达初级护理中心的中位时间为1小时，而抵达医院的中位时间为11小时。该系列中有89例死亡（死亡率15.03%）。男性、农村居民、转诊状态及未使用特效解毒剂对生存有负面影响。
这项来自印度东部一家医院的大型前瞻性研究，不仅获取了中毒的发病率和性质数据，还获取了治疗趋势和死亡率结果数据。根据这些结果开展的实地研究将阐明其他问题。
