Abhilash Kundavaram Paul Prabhakar, Murugan Sanjay, Rabbi N Abel S, Pradeeptha Sharon, Kumar Sathish, Selvaraj Bagyalakshmi, Gunasekaran Karthik
Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2022 Jan;11(1):233-239. doi: 10.4103/jfmpc.jfmpc_1184_21. Epub 2022 Jan 31.
Deliberate self-poisoning and harm (DSPH) is an unabating problem with a wide variation in the methods used across the world. Hence, this study was conducted to understand the current spectrum of methods used for DSPH by patients in our geographic locality and catchment area with special emphasis on newer compounds and drugs used.
This retrospective study included patients presenting with DSPH to the emergency department (ED) between January 2017 and December 2018.
This study included 1802 patients, with a mean age of 32 ± 12.7 years. Of the patients, 85% were in the young to middle age group (16-45 years). Agrochemicals (n = 604, 33.5%), drugs (n = 498, 27.6%), plant toxins (n = 150, 8.3%) and rodenticides (n = 145, 8%) were the predominantly used compounds. The major emergency resuscitation procedures required in the ED were intubation (n = 321, 18%), vasopressor support (n = 73, 4%) and cardiopulmonary resuscitation (n = 27, 1.4%). A quarter (23.2%) was discharged stable from the ED, whereas a further 56.5% were discharged stable after hospital admission. The in-hospital mortality rate was 3% (n = 47). Multivariate logistic regression analysis showed rodenticides (odds ratio (OR): 22.32; 95% confidence interval (CI): 8.05-61.88; = 0.005) and plant poisons (OR: 23.92; 95% CI: 8.95-63.94; = 0.005) to be the independent predictors of mortality.
DSPH is prevalent in the highly productive young age group. Agrochemical ingestion and drug overdose are the most common methods used, whereas rodenticide and plant poisoning are associated with significant mortality.
蓄意自我中毒和伤害(DSPH)是一个持续存在的问题,世界各地使用的方法差异很大。因此,开展本研究以了解我们所在地理位置和集水区内患者用于DSPH的当前方法范围,特别强调使用的新型化合物和药物。
这项回顾性研究纳入了2017年1月至2018年12月期间到急诊科(ED)就诊的DSPH患者。
本研究纳入了1802例患者,平均年龄为32±12.7岁。其中,85%为青年至中年组(16 - 45岁)。主要使用的化合物为农用化学品(n = 604,33.5%)、药物(n = 498,27.6%)、植物毒素(n = 150,8.3%)和杀鼠剂(n = 145,8%)。急诊科所需的主要紧急复苏程序为插管(n = 321,18%)、血管活性药物支持(n = 73,4%)和心肺复苏(n = 27,1.4%)。四分之一(23.2%)的患者从急诊科稳定出院,另有56.5%的患者在入院后稳定出院。住院死亡率为3%(n = 47)。多因素逻辑回归分析显示,杀鼠剂(比值比(OR):22.32;95%置信区间(CI):8.05 - 61.88;P = 0.005)和植物中毒(OR:23.92;95%CI:8.95 - 63.94;P = 0.005)是死亡率的独立预测因素。
DSPH在高生产力的青年年龄组中普遍存在。摄入农用化学品和药物过量是最常用的方法,而杀鼠剂和植物中毒与显著的死亡率相关。