Acute poisoning cases admitted to a tertiary hospital emergency department: A Prospective and Discriptive Study

Year 2023, , 96 - 101, 27.12.2023

Abdussamed Vural , Levent Avsarogullari

https://doi.org/10.55994/ejcc.1377924

Abstract

Introduction
Acute poisoning, characterized by exposure to toxic substances for less than 24 hours, is a significant public health issue worldwide. Factors leading to poisoning vary by region, customs, and socioeconomic level. To prevent this, countries and regions should analyze etiological and demographic characteristics of poisoning and take precautions. This study aimed to determine demographic, etiologic, and clinical characteristics of acute poisoning cases.
Material and Method
The study analyzed sociodemographic factors, clinical outcomes, and the causes of poisoning. Patients who attempted suicide were consulted by psychiatry at the end of their follow-up. The data was analyzed using Windows SPSS 21.0, with p <0.05 considered statistically significant.
Results
A study of 236,464 patients admitted to the adult emergency department within a 6-month period found that 432 (0.18%) were diagnosed with acute poisoning. The most common cause of acute poisoning cases was suicide attempts. The most common exposure agents were analgesics and antidepressants. The proportion of females (75.2%) in suicide attempts and males (89.5%) in abuse was statistically significantly higher. Of the 286 patients with suicide attempts, 212 (74.1%) underwent psychiatric consultation in the emergency department. The predominant psychosocial factors contributing to suicide attempts were familial issues and socioeconomic insufficiency. The overall mortality rate in patients followed up for acute poisoning was 0.46%.
Conclusion
The most common cause is intentional poisoning, particularly suicidal. Therapeutic drugs and food poisoning are the most common toxic agents. Family problems and socioeconomic inadequacy are common reasons for suicide attempts.

Keywords

Acute poisoning, epidemiology, emergency department, suicide

Ethical Statement

07/04/2014 under number 28

Supporting Institution

None

Thanks

None

References

• 1. Frithsen IL, Simpson WM Jr. Recognition and management of acute medication poisoning. Am Fam Physician. 2010 Feb 1;81(3):316-23. PMID: 20112890.
• 2. Zhang Y, Yu B, Wang N, Li T. Acute poisoning in Shenyang, China: a retrospective and descriptive study from 2012 to 2016. BMJ Open. 2018 Aug 29;8(8):e021881. doi: 10.1136/bmjopen-2018-021881. PMID: 30158226; PMCID: PMC6119445.
• 3. Senarathna L, Buckley NA, Jayamanna SF, Kelly PJ, Dibley MJ, Dawson AH. Validity of referral hospitals for the toxicovigilance of acute poisoning in Sri Lanka. Bull World Health Organ. 2012 Jun 1;90(6):436-443A. doi: 10.2471/BLT.11.092114. Epub 2012 Feb 28. PMID: 22690033; PMCID: PMC3370361.
• 4. Mazer-Amirshahi M, Sun C, Mullins P, Perrone J, Nelson L, Pines JM. Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003-2011. J Med Toxicol. 2016 Sep;12(3):248-54. doi: 10.1007/s13181-016-0564-6. Epub 2016 Jun 24. PMID: 27342464; PMCID: PMC4996794.
• 5. https://hsgm.saglik.gov.tr/depo/Yayinlarimiz/Raporlar/Ulusal_Zehir_Danisma_Merkezi_UZEM_Raporlari_2014-2020_Yillarr.pdf
• 6. Göney G. 1923’ten Günümüze Türkiye’de Zehirlenme Oranları Ve Nedenlerinin Analizi. SDÜ Tıp Fakültesi Dergisi. 2020; 27(Özel Sayı 1): 1-6.
• 7. Mowry JB, Spyker DA, Cantilena LR, JR, Mcmillan N, Ford M. 2013 Annual Report of the American Association of Poison Control Centers ’ National Poison Data System (NPDS): 31st Annual Report. Clinical Toxicology (2014), 52, 1032–1283. 2014 p. 1032–283.
• 8. Özköse Z, Ayoğlu F. Etiological and demographical characteristics of acute adult poisoning in Ankara, Turkey. Hum Exp Toxicol. 1999;18(August):614–8.
• 9. Goksu S, Yildirim C, Kocoglu H, Tutak A, Oner U. Characteristics of Acute Adult Poisoning in Gaziantep, Turkey. Clin Toxicol. 2002 Jan;40(7):833–7.
• 10. Pekdemir M, Kavalcı C, Durukan P, Yıldız M. Acil Servisimize Başvuran Zehirlenme Olgularının Değerlendirilmesi. Turk J Emerg Med. 2002;2(2):36–40.
• 11. Tüfekçi IB, Çurgunlu A, Şirin F. Characteristics of acute adult poisoning cases admitted to a university hospital in Istanbul. Hum Exp Toxicol. 2004 Jul 1;23(7):347–51.
• 12. Cengiz M, Baysal Z, Ganidagli S, Altindag A. Characteristics of poisoning cases in adult intensive care unit in Sanliurfa, Turkey. Saudi Med J. 2006;27(4):497–502.
• 13. McCaig LF, McCaig L, Burt CW. Poisoning-Related Visits to Emergency Departments in the United States, 1993–1996. Clin Toxicol. 1999 Jan;37(7):817–26.
• 14. Ponampalam R, Tan HH, Ng KC, Lee WY, Tan SC. Demographics of toxic exposures presenting to three public hospital emergency departments in Singapore 2001-2003. Int J Emerg Med. 2009 Apr;2(1):25–31.
• 15. Ayan M, Basol N, Karaman T, Tas U, Esen M. Retrospective Evaluation of Emergency Service Patients with Poisoning: a 20 Month Study. J Acad Emerg Med. 2012 Mar 1;11:146–50.
• 16. Çetin NG, Beydilli H, Tomruk Ö. Acil servise başvuran intoksikasyon olgularının geriye dönük analizi. SDÜ Tıp Fak Derg. 2004;11(4):7–9.
• 17. Sahin HA, Sahin I, Arabaci F. Sociodemographic factors in organophosphate poisonings: a prospective study. Hum Exp Toxicol. 2003;22(7):349–53.
• 18. Islambulchilar M, Islambulchilar Z, Kargar-Maher MH. Acute adult poisoning cases admitted to a university hospital in Tabriz, Iran. Hum Exp Toxicol. 2009 Apr;28(4):185–90.
• 19. Mert E, Bilgin N. Demographical, aetiological and clinical characteristics of poisonings in Mersin, Turkey. Hum Exp Toxicol. 2006;25(4):217–23.
• 20. Güloglu C, Kara I. Acute poisoning cases admitted to a university hospital emergency department in Diyarbakir, Turkey. Hum Exp Toxicol. 2005;24(2):49–55.
• 21. Baydin A, Yardan T, Aygun D, Doganay Z, Nargis C, Incealtin O. Retrospective evaluation of emergency service patients with poisoning: A 3-year study. Adv Ther. 2005;22(6):650–8.
• 22. Seydaoglu G, Satar S, Alparslan N. Frequency and mortality risk factors of acute adult poisoning in Adana, Turkey, 1997-2002. Mt Sinai J Med. 2005;72(6):393–401.
• 23. Hawton K, Fagg J, Simkin S, Mills J. The epidemiology of attempted suicide in the Oxford area, England (1989-1992). Crisis. 1994;15(3):123–35.
• 24. Wananukul W, Sriapha C, Tongpoo A, Sadabthammarak U, Wongvisawakorn S, Kaojarern S. Human poisoning in Thailand: The Ramathibodi Poison Center’s experience (2001-2004). Clin Toxicol (Phila). 2007;45(5):582–8.
• 25. Akkose S, Fedakar R, Bulut M, Çebiçci H. Acute poisoning in adults in the years 1996-2001 treated in the Uludag University Hospital, Marmara Region, Turkey. Clin Toxicol. 2005;43(2):105–9.
• 26. Eddleston M. Patterns and problems of deliberate self-poisoning in the developing world. QJM. 2000;93(11):715–31.
• 27. Hawton K. Deliberate self-harm. Medicine (Baltimore). 2004;32:38–42.
• 28. Schmidtke A, Bille-Brahe U, DeLeo D, Kerkhof A, Bjerke T, Crepet P, et al. Attempted suicide in Europe : rates, trend. S and sociodemogra phic characteristics of suicide attempters during the period 1989-1992. Results of the WHO / EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand. 1996;93:327–38.
• 29. Zebley BD, Ferrando SJ. Suicide-related events in patients treated with antiepileptic drugs. N Engl J Med. 2010;363(6):542–51.