El-Sarnagawy Ghada N, Abd Eldayem Yara B, Sobeeh Fatma Gaber
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Toxicol Rep. 2025 Feb 21;14:101973. doi: 10.1016/j.toxrep.2025.101973. eCollection 2025 Jun.
Timely antidote administration is a critical step in acute poisoning management. Awareness of poisoning patterns and the essential antidotal requirement could improve patient care with better hospital resource allocation. This study investigates the pattern and impact of antidotal administration on patient outcomes in an Egyptian tertiary poison control center, providing insights to optimize the antidote stocking of essential antidotes. A three-year cross-sectional study was conducted at Tanta University Poison Control Center from January 2021 to December 2023. Demographic data, poisoning characteristics, causative agents, and administered antidotal data were retrieved. The initial Poisoning Severity Score (PSS), total hospitalization period, and patient outcomes were also recorded. The included 447 antidote-treated poisoned patients showed near equal gender distribution and median age of 25 years. Atropine, oximes, N-acetylcysteine (NAC), and naloxone were the top administered antidotes among patients (48.3 %, 25.7 %, 19.9 %, and 11.2 %, respectively). Mortality and complications were recorded in 5.15 % and 20.8 %, respectively. Administration of atropine, oximes, NAC, and L-carnitine significantly improved all outcomes ( < 0.05). Although HBO therapy significantly improved mortality, it substantially increased intensive care unit admissions ( < 0.001). Despite folic acid administration significantly improved mortality and complication incidences ( < 0.05), its therapeutic efficiency is still questionable. Availability constraints of the digibind and botulinum antitoxin could affect patient outcomes. Administration of atropine, oximes, NAC, naloxone, and sodium bicarbonate was significantly linked to prolonged hospitalization ( < 0.001). Accordingly, the emergency department in each institution should regularly update the antidotal stock based on a review of the list of essential and commonly used antidotes.
及时给予解毒剂是急性中毒治疗的关键步骤。了解中毒模式和必要的解毒剂需求有助于优化医院资源分配，从而改善患者护理。本研究调查了埃及一家三级中毒控制中心解毒剂使用模式及其对患者预后的影响，旨在为优化基本解毒剂储备提供参考。2021年1月至2023年12月，在坦塔大学中毒控制中心开展了一项为期三年的横断面研究。收集了人口统计学数据、中毒特征、致病因素及所用解毒剂数据。同时记录初始中毒严重程度评分（PSS）、总住院时间和患者预后情况。纳入的447例接受解毒剂治疗的中毒患者中，性别分布接近均等，中位年龄为25岁。阿托品、肟类、N - 乙酰半胱氨酸（NAC）和纳洛酮是最常用的解毒剂（分别占48.3%、25.7%、19.9%和11.2%）。死亡率和并发症发生率分别为5.15%和20.8%。使用阿托品、肟类、NAC和L - 肉碱均显著改善了各项预后指标（P<0.05）。尽管高压氧治疗显著降低了死亡率，但大幅增加了重症监护病房的入院率（P<0.001）。尽管使用叶酸显著降低了死亡率和并发症发生率（P<0.05），但其治疗效果仍存疑问。地高辛抗体片段和肉毒抗毒素的供应受限可能影响患者预后。使用阿托品、肟类、NAC、纳洛酮和碳酸氢钠与住院时间延长显著相关（P<0.001）。因此，各机构急诊科应定期根据基本和常用解毒剂清单审查结果更新解毒剂储备。
