Pannu Ashok Kumar, Bhalla Ashish, Vamshi Vitla, Upadhyay Manish Kumar, Sharma Navneet, Kumar Susheel
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Turk J Emerg Med. 2022 Sep 28;22(4):192-199. doi: 10.4103/2452-2473.357627. eCollection 2022 Oct-Dec.
Evaluating local trends and continued monitoring of patterns of acute poisoning are essential for prompt recognition of the toxidromes, the establishment of immediate treatment facilities (e.g., antidote availability), and effective preventive strategies (e.g., governmental regulation on hazardous substances marketing). We aimed to describe the prevalence of the various types of poisoning and associated case fatality in our academic hospital in North India.
A prospective observational descriptive study was conducted, enrolling patients aged ≥13 years with acute poisoning for 17 months from December 2016 to December 2017 and from September 2019 to December 2019, for a total of 17 months.
Four hundred and two patients were enrolled (median age 28 years; 63.2% males). Majority of the acute poisoning cases resulted from ingestion ( = 391, 97.3%) and the primary intention was most commonly self-harm ( = 314, 78.1%). The major types of poisoning were pesticide ( = 264, 65.7%), drug overdose ( = 77, 19.2%), and corrosive ingestion ( = 31, 7.7%). Pesticides included insecticides ( = 146, 36.3%; cholinesterase inhibitors, = 91), fungicides ( = 76, 18.9%; all aluminum phosphide), herbicides ( = 22, 5.5%; paraquat, = 19), and rodenticides ( = 20, 5.0%; coumarin-derived substances, = 12). Benzodiazepines ( = 33) and opioids ( = 25) were frequent causes of drug overdose. 95.3% ( = 379) received preliminary treatment at the previous health-care center, including gastric lavage ( = 239) and antidotes ( = 73). In-hospital case fatality rate was 17.3% ( = 58).
Herbicide ingestion and opioid overdose are emerging threats with a gradual decline in organophosphate and aluminum phosphide poisoning. Despite improving management of acute poisoning, the overall case fatality rate remains substantial.
评估当地急性中毒趋势并持续监测中毒模式，对于迅速识别中毒综合征、建立即时治疗设施（如解毒剂供应）以及有效的预防策略（如政府对有害物质销售的监管）至关重要。我们旨在描述印度北部我们学术医院中各类中毒的患病率及相关病死率。
开展了一项前瞻性观察性描述性研究，纳入年龄≥13岁的急性中毒患者，研究时间为2016年12月至2017年12月以及2019年9月至2019年12月，共17个月。
共纳入402例患者（中位年龄28岁；男性占63.2%）。大多数急性中毒病例是由于摄入（n = 391，97.3%），主要意图最常见的是自我伤害（n = 314，78.1%）。主要的中毒类型为农药中毒（n = 264，65.7%）、药物过量中毒（n = 77，19.2%）和腐蚀性物质摄入中毒（n = 31，7.7%）。农药包括杀虫剂（n = 146，36.3%；胆碱酯酶抑制剂，n = 91）、杀菌剂（n = 76，18.9%；均为磷化铝）、除草剂（n = 22，5.5%；百草枯，n = 19）和灭鼠剂（n = 20，5.0%；香豆素类物质，n = 12）。苯二氮䓬类药物（n = 33）和阿片类药物（n = 25）是药物过量中毒的常见原因。95.3%（n = 379）的患者在之前的医疗机构接受了初步治疗，包括洗胃（n = 239）和解药（n = 73）。院内病死率为17.3%（n = 58）。
除草剂摄入和阿片类药物过量中毒是新出现的威胁，有机磷和磷化铝中毒呈逐渐下降趋势。尽管急性中毒的管理有所改善，但总体病死率仍然很高。
