Duan Zhu Yan, Qu Yan Ning, Tang Rui, Liu Jun Ting, Wang Hui, Sheng Meng Yi, Wang Liang Liang, Liu Shuang, Li Jiao, Guo Lin Ying, Zheng Si
Emergency Department, Capital Center for Children's Health, Capital Medical University, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China, 86 13020013651.
Capital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
JMIR Pediatr Parent. 2025 Jun 17;8:e66951. doi: 10.2196/66951.
Acute pharmaceutical exposure in children can lead to severe health outcomes and contribute to the inefficient use of medical resources.
This study aimed to investigate the clinical characteristics and outcomes of children with acute pharmaceutical exposure to guide the development of preventive strategies and educational initiatives.
We analyzed real-world data from electronic medical records of children admitted to the emergency department of a pediatric hospital for acute pharmaceutical exposure between January 2019 and December 2023. Clinical data, including laboratory test results, interventions, and outcomes, were collected. We compared different exposure events and conducted logistic regression analysis to identify risk factors for hospitalization.
A total of 653 children were included in the study. The most common drugs involved in exposure were vitamins (149/653, 22.8%), nonsteroidal anti-inflammatory drugs (92/653, 14.1%), and psychiatric drugs (74/653, 11.3%). In total, 74.3% (469/631) of patients with complete clinical manifestation data showed no symptoms after exposure, and 68.1% (445/653) of patients did not require specific therapy. Toxicology screening was performed for 11% (72/653) of the children, and 69.4% (50/72) of these tests were positive. Independent risk factors for hospitalization included multisystem involvement (odds ratio [OR] 4.575, 95% CI 1.709-12.251, P=.002), psychiatric drugs (OR 6.280, 95% CI 2.189-18.020, P=.001), and intentional poisoning (OR 12.892, 95% CI 2.222-74.796, P=.004).
Children with acute pharmaceutical exposure exhibit diverse clinical characteristics and outcomes, with most requiring no specific treatment. However, immediate toxicology screening and clinical intervention are essential for those exhibiting rapidly developing or multisystem symptoms, as well as those with intentional exposure or exposure to known highly toxic substances. Future pediatric health care policies should emphasize safe storage practices and public education on the prevention of pharmaceutical exposure.
儿童急性药物暴露可导致严重的健康后果，并造成医疗资源的低效利用。
本研究旨在调查儿童急性药物暴露的临床特征和结局，以指导预防策略的制定和教育举措。
我们分析了2019年1月至2023年12月期间因急性药物暴露入住一家儿科医院急诊科的儿童电子病历中的真实世界数据。收集了临床数据，包括实验室检查结果、干预措施和结局。我们比较了不同的暴露事件，并进行逻辑回归分析以确定住院的危险因素。
本研究共纳入653名儿童。暴露涉及的最常见药物为维生素（149/653，22.8%）、非甾体抗炎药（92/653，14.1%）和精神药物（74/653，11.3%）。在有完整临床表现数据的患者中，总计74.3%（469/631）在暴露后无症状，68.1%（445/653）的患者不需要特殊治疗。对11%（72/653）的儿童进行了毒理学筛查，其中69.4%（50/72）的检测结果为阳性。住院的独立危险因素包括多系统受累（比值比[OR]4.575，95%置信区间1.709-12.251，P = 0.002）、精神药物（OR 6.280，95%置信区间2.189-18.020，P = 0.001）和故意中毒（OR 12.892，95%置信区间2.222-74.796，P = 0.004）。
急性药物暴露的儿童表现出多样的临床特征和结局，大多数不需要特殊治疗。然而，对于那些出现快速进展或多系统症状的儿童，以及故意暴露或暴露于已知高毒物质的儿童，立即进行毒理学筛查和临床干预至关重要。未来的儿科医疗保健政策应强调安全储存做法以及关于预防药物暴露的公众教育。
