Qu Yanning, Tang Rui, Duan Zhuyan, Sheng Mengyi, Wang Hui, Liu Shuang, Li Jiao, Guo Linlin, Guo Linying, Zheng Si
Department of Critical Care Medicine, Children's Hospital Affiliated to Capital Institute Pediatrics, Beijing, China.
Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Public Health. 2025 Feb 5;13:1510205. doi: 10.3389/fpubh.2025.1510205. eCollection 2025.
This study aims to systematically analyze the epidemiological characteristics, clinical interventions and outcomes of children with acute non-pharmaceutical toxic exposures.
This retrospective study included all children with acute non-pharmaceutical toxic exposure admitted to the emergency department of the Capital Institute of Pediatrics between January 1, 2019, and December 31, 2023. Eligible patients were triaged into red, yellow, and green groups according to their severity condition. Clinical information including demographics, exposure details, clinical manifestation, laboratory results, treatments, and outcomes were extracted from electronic medical records. Univariate and multivariate logistic regression analyses were conducted to identify risk factors associated with hospitalization.
Overall, a total of 718 patients with acute non-pharmaceutical toxic exposures was included in this study, infants and toddlers accounting for 57.9%. The male-to-female ratio was 1.16:1. The majority exposure events occurred at home (89.3%) and in urban settings (78.4%). Accidental poisoning was the predominant cause, accounting for 94.7%, and the primary route of exposure was oral (93.6%). Mercury was the most common exposed substance, representing 18.8% of cases, particularly among preschool-aged children (31.7%). Patients triaged to red zone had a higher proportion of clinical manifestation and required more aggressive treatments. Although most patients discharged without treatment (78.4%), 19.1% need emergency observation, and 2.5% required hospitalization. Logistic regression analysis showed that corrosive household products exposure (OR = 42.747, 95% CI[5.041-362.520]), skin and mucosal damage (OR = 37.052, 95% CI[5.339-257.153]), pesticides exposure (OR = 33.322, 95% CI[3.863-287.423]), heavy metals exposure (OR = 31.636, 95% CI[1.471-680.210]), neurological manifestation (OR = 22.656, 95% CI[4.766-107.711]), positive toxicology results (OR = 15.105, 95% CI[6.584-34.656]), industrial products exposure (OR = 10.294, 95% CI[1.144-92.641]), and intentional poisoning (OR = 3.060, 95% CI[1.733-5.405]) associated with hospitalization.
Pediatric patients exposed to some specific toxicants like industrial products and corrosive household products might associated with a higher risk of severe clinical outcomes. Advocating for enhanced safety regulations or educations and public health initiatives to mitigate the incidence of such exposures is still important for protecting children's health.
本研究旨在系统分析急性非药物性中毒儿童的流行病学特征、临床干预措施及结局。
本回顾性研究纳入了2019年1月1日至2023年12月31日期间首都儿科研究所急诊科收治的所有急性非药物性中毒儿童。符合条件的患者根据病情严重程度分为红、黄、绿三组。从电子病历中提取人口统计学、暴露细节、临床表现、实验室检查结果、治疗及结局等临床信息。进行单因素和多因素逻辑回归分析以确定与住院相关的危险因素。
本研究共纳入718例急性非药物性中毒患者，婴幼儿占57.9%。男女比例为1.16:1。大多数暴露事件发生在家中（89.3%）且在城市环境中（78.4%）。意外中毒是主要原因，占94.7%而主要暴露途径为经口（93.6%）。汞是最常见的暴露物质，占病例的18.8%，尤其在学龄前儿童中（31.7%）。分诊至红色区域的患者临床表现比例较高且需要更积极的治疗。尽管大多数患者未经治疗出院（78.4%），但19.1%需要急诊观察，2.5%需要住院治疗。逻辑回归分析显示，接触腐蚀性家用产品（OR = 42.747，95%CI[5.041 - 362.520]）、皮肤和黏膜损伤（OR = 37.05, 95%CI[5.339 - 257.153]）、接触农药（OR = 33.322，95%CI[3.863 - 287.423]）、接触重金属（OR = 31.636，95%CI[1.471 - 680.210]）、神经系统表现（OR = 22.656，95%CI[4.766 - 107.711]）、毒理学结果阳性（OR = 15.105，95%CI[6.584 - 34.656]）、接触工业产品（OR = 10.294，95%CI[1.144 - 92.641]）及故意中毒（OR = 3.060，95%CI[1.733 - 5.405]）与住院相关。
接触某些特定毒物如工业产品和腐蚀性家用产品的儿科患者可能有更高的严重临床结局风险。倡导加强安全法规或教育以及公共卫生举措以降低此类暴露的发生率对于保护儿童健康仍然很重要。
