From the Department of Pediatrics, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
King's College London, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
Pediatr Emerg Care. 2022 Feb 1;38(2):e659-e663. doi: 10.1097/PEC.0000000000002429.
Acute poisoning is a significant and preventable cause of mortality among children internationally. The aims of this study were to assess the case fatality rate of children admitted to an inner-city hospital for acute poisoning and to compare the demographics and source of poisoning of fatal cases.
This was a retrospective review of patient data recorded in the Hospital Information System for Loghman Hakim Hospital, that is, the central referral hospital for poisoning in Tehran, Iran. We searched Hospital Information System for all admissions for poisoning in children (age, 0-12 years) over the 10-year period from March 2010 to March 2020, and all cases were included in the analysis. We determined the case fatality rate by dividing the number of fatal cases by the number of included cases.
Of 8158 children admitted for poisoning, 28 cases (0.3%) died, among whom 19 (67.9%) were boys and 9 (32.1%) girls. The median age was 42 months, ranging from 2 to 144 months. Twenty-two cases (78.6%) were 0 to 5 years old. The most common cause of mortality in acute poisoning was methadone (n = 13, 46.4%), followed by raw opium (n = 5, 17.9%), aluminum phosphide, carbon monoxide, and wild mushrooms (n = 2 deaths each, 7.1%). Tramadol, colchicine, and petroleum accounted for 1 death each (3.6%).
Mortality from unintentional poisoning disproportionately affects children younger than 5 years. Opioids (ie, methadone, opium, tramadol) accounted for two thirds of deaths in our sample. Our findings highlight the importance of educating parents that any toxic materials (licit or illicit) must be stored out of reach for children.
急性中毒是国际上导致儿童死亡的一个重要且可预防的原因。本研究旨在评估因急性中毒而入住市区医院的儿童的病死率，并比较死亡病例的人口统计学特征和中毒来源。
这是对伊朗德黑兰洛因哈基姆医院（伊朗中毒的中心转诊医院）医院信息系统中记录的患者数据进行的回顾性分析。我们在 10 年期间（2010 年 3 月至 2020 年 3 月）搜索了医院信息系统中所有年龄在 0-12 岁的儿童因中毒住院的记录，所有病例均纳入分析。我们通过将死亡病例数除以纳入病例数来确定病死率。
在因中毒而住院的 8158 名儿童中，有 28 例（0.3%）死亡，其中 19 例（67.9%）为男孩，9 例（32.1%）为女孩。中位年龄为 42 个月，范围为 2-144 个月。22 例（78.6%）为 0-5 岁。急性中毒导致死亡的最常见原因是美沙酮（n = 13，46.4%），其次是生鸦片（n = 5，17.9%）、磷化铝、一氧化碳和野生蘑菇（n = 2 例死亡，7.1%）。曲马多、秋水仙碱和石油各导致 1 例死亡（3.6%）。
意外中毒导致的死亡率不成比例地影响 5 岁以下的儿童。在我们的样本中，阿片类药物（即美沙酮、鸦片、曲马多）占死亡人数的三分之二。我们的研究结果强调了教育父母的重要性，即任何有毒物质（合法或非法）都必须放在儿童够不着的地方。
