From the Department of Pediatrics.
Pediatric Intensive Care Division, Department of Pediatrics, Health Sciences University, Van Research and Training Hospital, Van.
Pediatr Emerg Care. 2023 Oct 1;39(10):766-772. doi: 10.1097/PEC.0000000000003041. Epub 2023 Sep 4.
Poisonings constitute an important part of preventable morbidity and mortality in pediatric intensive care units (PICUs) and hospitalizations. However, information on poisoning requiring intensive care is limited. This study aimed epidemiological evaluation of poisoning cases treated in the PICU in a single center.
The records of 504 patients admitted to the PICU due to acute poisoning between 2010 and 2022 were retrospectively reviewed. Data were evaluated using descriptive methods and the χ 2 test, and statistical differences with P value <0.05 were considered significant.
The age range of the patients ranged from 1 month to 216 months (18 years), and the rate of girls was 53.2% (n = 268), whereas the rate of boys was 46.8% (n = 236). The mean age was 4.4 ± 4.3 years for boys, 6.7 ± 5.8 years for girls, and 5.6 ± 5.3 years for all patients. It was determined that 79.6% of the cases were poisoned by accident and 20.4% by suicide. A total of 76.7% of the patients who were poisoned for suicide were girls and 23.3% were boys. The mean age of these patients was 14.3 ± 3.0 years. On the other hand, 47.1% of the children who were accidentally poisoned were girls and 52.9% were boys, and the mean age of these children was 3.4 ± 2.9 years. Although 79.9% of poisonings occurred at home, the causative agent was oral poisoning in 97.4% of the cases. Approximately two thirds (69.2%) of the cases were drug-related, whereas 30.8% were related to nondrug substances. In drug-related poisonings, central nervous system drugs (35.8%) were the most common agent, followed by analgesic/antipyretic (20.9%) agents, whereas among the nonpharmaceutical factors, insecticides (agricultural pesticides, rat poison, pesticides, etc) were the most common, followed by poisonous herbs (beetleweed, widow's weed, cannabis, etc). The mean admission time of the patients to the hospital was 6.3 ± 8.4 hours, and the mean length of stay in the intensive care unit was 1.6 ± 1.3 days. In the 12 years of our study, only 3 patients died due to poisoning, and our mortality rate was 0.5%. Four patients (0.7%) were referred to the Alcohol and Drug Addicts Treatment and Research Center.
In this study, in which we retrospectively analyzed the profiles of poisoning cases hospitalized in the PICU for 12 years, we determined that poisonous weeds were the major factor in accidental poisonings, and suicidal poisonings were above the expected rates even at the young age group such as 8-12 years old. These results show the importance of determining the poisoning profile of the health care service area.
中毒是儿科重症监护病房(PICU)和住院患者可预防发病率和死亡率的重要组成部分。然而,关于需要重症监护的中毒信息有限。本研究旨在对单中心 PICU 治疗的中毒病例进行流行病学评估。
回顾性分析了 2010 年至 2022 年期间因急性中毒入住 PICU 的 504 例患者的记录。使用描述性方法和卡方检验评估数据,P 值<0.05 被认为具有统计学差异。
患者年龄范围为 1 个月至 216 个月(18 岁),女孩比例为 53.2%(n=268),男孩比例为 46.8%(n=236)。男孩的平均年龄为 4.4±4.3 岁,女孩为 6.7±5.8 岁,所有患者为 5.6±5.3 岁。确定 79.6%的病例为意外中毒,20.4%为自杀中毒。自杀中毒的患者中,76.7%为女孩,23.3%为男孩。这些患者的平均年龄为 14.3±3.0 岁。另一方面,47.1%的意外中毒儿童为女孩,52.9%为男孩,这些儿童的平均年龄为 3.4±2.9 岁。尽管 79.9%的中毒发生在家庭中,但 97.4%的中毒原因是口服中毒。大约三分之二(69.2%)的病例与药物有关,而 30.8%与非药物物质有关。在与药物相关的中毒中,中枢神经系统药物(35.8%)是最常见的药物,其次是镇痛药/退烧药(20.9%),而非药物因素中,杀虫剂(农业杀虫剂、老鼠药、杀虫剂等)是最常见的,其次是有毒草药(甲虫草、寡妇草、大麻等)。患者入院时间的平均值为 6.3±8.4 小时,重症监护病房住院时间的平均值为 1.6±1.3 天。在我们 12 年的研究中,只有 3 名患者因中毒死亡,死亡率为 0.5%。4 名患者(0.7%)被转至酒精和药物滥用治疗与研究中心。
在本研究中,我们回顾性分析了 12 年来在 PICU 住院的中毒病例,确定有毒杂草是意外中毒的主要因素,即使在 8-12 岁这样的年轻年龄段,自杀中毒的比例也高于预期。这些结果表明确定医疗服务区域中毒情况的重要性。