儿科重症监护病房中的法医病例评估

Evaluation of Forensic Cases in the Pediatric Intensive Care Unit.

作者信息

Polat Sinem, Terece Cem, Yaman Ayhan, Gurpinar Kagan

机构信息

Department of Pediatrics, Istinye University Faculty of Medicine, Pediatric Emergency Care Unit, Istanbul Turkey.

Second Forensic Medicine Specialization Board, Council Of Forensic Medicine, İstanbul, Turkey.

出版信息

Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):122-127. doi: 10.14744/SEMB.2019.73693. eCollection 2021.

DOI:10.14744/SEMB.2019.73693

PMID:33935546

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8085442/

Abstract

OBJECTIVES

Traffic accidents, falls, assaults, occupational accidents, intoxications, burns, electric shock, lightning strike, all cases of asphyxia, penetrating and firearm injuries, suspected or definite cases of sexual abuse, and suicide attempts should be evaluated in the forensic category. In this study, we aimed to present our intensive care experiences in forensic cases.

METHODS

We retrospectively evaluated forensic cases admitted to our Pediatric Intensive Care Unit between 1 February 2017 and 1 September 2018.

RESULTS

This study included 153 children, 65 (42.5%) boys and 88 (57.5%) girls. The forensic causes of hospitalizations in the intensive care unit included drug intoxication with a rate of 54.9%, followed by suicide attempts with 24.2%, falling from a high place with 5.2%, child abuse with 5.2%, pedestrian (out-of-vehicle) traffic accidents with 2.6%, drowning in water with 2.6%, road (in-vehicle) traffic accidents with 2%, electric shocks with 2%, and CO (carbon monoxide) poisoning with 1.3%. The drug intoxication was caused by drugs prescribed to the mother and the child with a rate of 40.6% and 27.1%, respectively. Analgesic anti-inflammatory drugs (33.1%) and antidepressant drugs (22.3%) were identified as major causes of intoxication. In addition, paracetamol was the most common cause of intoxication, with a rate of 21.9% among all intoxication cases and 72.5% in the analgesic group. Amitriptyline was the most common agent in the antidepressant group (59.2%). The admission rate to the intensive care unit between 08:00 and 14:00 was 35.1% for suicide attempts and 16.4% for non-suicide attempts, with a statistically significant difference (p=0.025; p<0.05, respectively).

CONCLUSION

Drug intoxications had the highest rate of forensic cases followed in our pediatric intensive care unit. The majority of these intoxications (69.4%) arose from accidental drug ingestion. Therefore, we believe that there may be a significant decrease in the number of hospitalizations of forensic cases associated with drug intoxications in pediatric intensive care units by preventing children's access to drugs.

摘要

目的

交通事故、跌倒、袭击、职业事故、中毒、烧伤、电击、雷击、所有窒息病例、穿透伤和火器伤、疑似或确诊的性虐待病例以及自杀未遂病例均应在法医类别中进行评估。在本研究中，我们旨在介绍我们在法医病例中的重症监护经验。

方法

我们回顾性评估了2017年2月1日至2018年9月1日期间入住我们儿科重症监护病房的法医病例。

结果

本研究纳入了153名儿童，其中65名（42.5%）为男孩，88名（57.5%）为女孩。重症监护病房住院的法医原因包括药物中毒，发生率为54.9%，其次是自杀未遂，占24.2%，高处坠落占5.2%，虐待儿童占5.2%，行人（车外）交通事故占2.6%，溺水占2.6%，道路（车内）交通事故占2%，电击占2%，一氧化碳中毒占1.3%。药物中毒分别由开给母亲和孩子的药物引起，发生率分别为40.6%和27.1%。镇痛抗炎药（33.1%）和抗抑郁药（22.3%）被确定为中毒的主要原因。此外，扑热息痛是最常见的中毒原因，在所有中毒病例中占21.9%，在镇痛组中占72.5%。阿米替林是抗抑郁药组中最常见的药物（59.2%）。自杀未遂者在08:00至14:00期间入住重症监护病房的比例为35.1%，非自杀未遂者为16.4%，差异有统计学意义（p=0.025；p<0.05）。