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Çocuklarda akut zehirlenme; 2015 yılında Marmara Üniversitesi Hastanesi’ne başvuran olguların değerlendirilmesi

Year 2018, Volume: 31 Issue: 3, 120 - 125, 31.10.2018
https://doi.org/10.5472/marumj.474194

Abstract

Amaç: Türkiye İstatistik Kurumu 2015 verilerine göre; 1-17 yaş
grubunda 6477 çocuğun öldüğü, bu ölümlerin %29,5’inin
(n=1909) dış sebeplere bağlı yaralanmalar ve zehirlenmeler
nedeniyle olduğu belirtilmiştir. Amacımız, çocukların demografik
bilgilerini, klinik özelliklerini, zehirlenmenin sebep ve sonuçlarını
değerlendirerek bu soruna çözüm üretmektir.
Gereç ve Yöntem: Marmara Üniversitesi Hastanesi Çocuk
Acil Servisi’ne 2015 yılı buyunca akut zehirlenme ile başvuran
çocukların hastane kayıtları retrospektif olarak değerlendirilmiştir.
Bulgular: 2015 yılında zehirlenme nedeniyle toplam 1110 olgu
başvurmuştur. Bunların %31,6 (n=351) çocuktur, bu çocukların
yaklaşık yarısı erkek (n= 173) yarısı da kızdır (n= 178). Erkeklerin
yaş ortalaması 6,24 yıl, kızların ise 8,47 yıldır. Hastaların %60’ı
(n=213) 0-6 yaş aralığında, %8’i (n=28) 7-11 yaş aralığında,
%32’si (n=110) 12-18 yaş aralığındadır. %46.1’i (n=162) ilaçla
zehirlenmiştir. İlaçlarda parasetamol %14,8’i ile en sık kullanılan
etkendir. İlaç dışı etkenlerde ise kostik/koroziv maddeler (deterjan,
çamaşır suyu, aseton vb) %54 ile en sık kullanılan etkendir.
Sonuç: Bu çalışmadaki olguların %80,3’ünü (tüm olgulardaki
kazaya bağlı zehirlenme oranı) gerekli düzenleme ve tedbirlerle
önlenebilir nitelikte olan zehirlenmeler oluşturmaktadır. Çocuğa
dirençli paketleme ile ilgili düzenlemeler bir an önce yürürlüğe
konmalıdır.

References

  • 1. Peden M, Oyegbite K, Ozanne-Smith J, et al. Poisoning. In: World Report on Child Injury Prevention. Geneva, Switzerland; 2008.
  • 2. Özcan N, İkincioğulları D. Ulusal zehi̇r danişma merkezi̇ 2008 yılı çalışma raporu özeti. Türk Hij Den Biyol Derg 2009; 66:29-58.
  • 3. Lamireau T, Llanas B, Kennedy A, et al. Epidemiology of poisoning in children: a 7-year survey in a paediatric emergency care unit. Eur J Emerg Med 2002;9:9-14.
  • 4. Kivistö JE, Arvola T, Parkkari J, Mattila VM. Paediatric poisonings treated in one Finnish main university hospital between 2002 and 2006. Acta Paediatr 2008;97:790-4. doi:wiley.com/10.1111/j.1651-2227.2008.00771.x
  • 5. Baker R, Orton E, Tata LJ, Kendrick D. Epidemiology of poisonings, fractures and burns among 0–24 year olds in England using linked health and mortality data. Eur J Public Health 2016;26:940–6. doi:10.1093/eurpub/ckw064
  • 6. Manouchehrifar M, Derakhshandeh N, Shojaee M, Sabzghabaei A, Farnaghi F. An epidemiologic study of pediatric poisoning; A six-month cross-sectional study. Emergency 2016;4:21-4.
  • 7. Karaci M, Yildiz N, Metin O, Ozcetin M. A retrospective study of childhood intoxication in the Zonguldak region. J Acad Emerg Med 2013;12:145-9.
  • 8. Kivistö JE, Parkkari J, Mattila VM, Hoppu K. Poisoning deaths among Finnish children from 1969 to 2003. Acta Paediatr 2009;98:1661-6. doi:10.1111/j.1651-2227.2009.01408.x
  • 9. Özdemir R, Bayrakcı B, Teküam Ö, Yalçın B, Kale G. Thirtythree- year experience on childhood poisoning. Turk J Pediatr 2012;54:251-9.
  • 10. Andiran N, Sarikayalar F. Pattern of acute poisonings in childhood in Ankara: what has changed in twenty years? Turk J Pediatr 2004;46:147-52.
  • 11. Akgül F, Er A, Çelebi Çelik F, et al. Retrospective Analysis of Childhood Poisoning. Turkish J Pediatr Emerg Intensive Care Med 2016;91-6.
  • 12. Schmertmann M, Williamson A, Black D. Unintentional poisoning in young children: does developmental stage predict the type of substance accessed and ingested? Child Care Health Dev 2014;40:50-9.
  • 13. Fergusson DM, Horwood LJ, Beautrais AL, Shannon FT. A controlled field trial of a poisoning prevention method. Pediatrics 1982;69:515-20.
  • 14. Anderson AC. Iron poisoning in children. Curr Opin Pediatr 1994;6:289-94.
  • 15. Ramos CL, Barros HM, Stein AT, Costa JS. Risk factors contributing to childhood poisoning. J Pediatr (Rio J) 2010;86:435-40.
  • 16. Sethi D, Towner E, Vincenten J, Gomez-Segui M, Racioppi F. Poisoning. In: European Report on Child Injury Prevention. Geneva, Switzerland; 2008.
  • 17. Hawton K, Bergen H, Waters K, et al. Epidemiology and nature of self-harm in children and adolescents: findings from the multicentre study of self-harm in England. Eur Child Adolesc Psychiatry 2012;21:369-77. doi:10.1007/ s00787-012-0269-6
  • 18. Prescott K, Stratton R, Freyer A, Hall I, Le Jeune I. Detailed analyses of self-poisoning episodes presenting to a large regional teaching hospital in the UK. Br J Clin Pharmacol 2009;68:260-8.
  • 19. Rodrigues Mendonça D, Menezes MS, Matos MAA, et al. Acute poisoning in children in Bahia, Brazil. Glob Pediatr Heal 2016;3:2333794X15623243. doi:10.1177/2333794X15623243
  • 20. Chowdhury AN, Banerjee S, Brahma A, Biswas MK. A study on mortality and morbidity pattern of acute childhood poisoning cases admitted in block primary health centres of Sundarban, West Bengal. Indian J Public Health 2008;52:40-2.
  • 21. Hoikka M, Liisanantti J, Dunder T. Acute poisoning in children under the age of six: a two-decade study of hospital admissions and trends. Acta Paediatr 2013;102:e329-33. doi:10.1111/apa.12238
  • 22. Akici N, Bayoğlu D, Gürbüz T, Önal E, Nuhoğlu Ç, Akici A. Alti yas ve altindaki çocuklarda ve alti yasindan büyük çocuklarda karsilasilan zehirlenmelerin arastirilmasi. Marmara Pharm J 2013;1:35-41.
  • 23. Eliaçık K, Kanık A, Karanfil Ö, Rastgel H. Bir üçüncü basamak hastane çocuk acil servisine başvuran zehirlenme vakalarının değerlendirilmesi. Symrna Tıp Derg 2012;1:41- 4.
  • 24. Mintegi S, Fernandez A, Alustiza J, et al. Emergency visits for childhood poisoning. Pediatr Emerg Care 2006;22:334-8.
  • 25. Yates KM. Accidental poisoning in New Zealand. Emerg Med 2003;15:244-9.
  • 26. Çam H, Kıray E, Taştan Y, Çerçi Özkan H. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Acil servisinde izlenen zehirlenme olguları. Türk Pediatr Arşivi 2003;38:233-9.
  • 27. Bükülmez A, Tahta EG, Şen TA, Alpay F. Çocuk Acil Servisine başvuran zehirlenme vakalarının değerlendirilmesi. Kocatepe Tıp Derg 2013;14:11-6.
  • 28. Poyraz Fındık OT, Akıcı N, Kırmızı Nİ, Tıplamaz S, Akıcı A. What should be the age limit for the children to access medications on their own?: Review. Turkiye Klin J Med Sci 2016;36:171-84.
  • 29. Öner N, İnan M, Vatansever Ü, et al. Trakya bölgesinde çocuklarda görülen zehirlenmeler. Türk Pediatr Arşivi 2004;39:25-30.
  • 30. Yin S. Malicious use of pharmaceuticals in children. J Pediatr 2010;157:832-6.
  • 31. Yin S. Malicious use of nonpharmaceuticals in children. Child Abuse Negl 2011;35:924-9. doi:10.1016/j.chiabu.2011.05.01
  • 32. Dinis-Oliveira RJ, Magalhães T. Children intoxications: what is abuse and what is not abuse. Trauma Violence Abuse 2013;14:113-32. doi:10.1177/1524838012470033
  • 33. Hines E. Child abuse by poisoning. Clin Pediatr Emerg Med [Internet]. 2016;17:296-301. doi:10.1016/j. cpem.2016.10.003
  • 34. Bateman DN. The epidemiology of poisoning. Medicine (Baltimore) 2007;35:537-9.
  • 35. Sandra Levy. CPSC to require child-resistant packaging on some household products. Drug Topics 2001;22.

Acute poisoning in children; Evaluation of cases admitted to Marmara University Hospital in 2015

Year 2018, Volume: 31 Issue: 3, 120 - 125, 31.10.2018
https://doi.org/10.5472/marumj.474194

Abstract

Objectives: According to Turkish Statistical Institute (TurkStat),
6477 children aged between 1 and 17 years, died in 2015 and
29.5% (n=1909) of these deaths were because of injuries due to
external causes and poisoning. Our aim is to produce solutions
to this problem by evaluating demographics, clinical features of
patients and the causes and consequences of poisoning.
Materials and Methods: The hospital medical records of
children who were admitted with acute intoxication to Pediatric
Emergency Service at Marmara University Hospital in 2015, were
evaluated retrospectively.
Results: In 2015, a total of 1110 patients applied to the hospital
due to poisoning. Of these cases, 31.6% (n = 351) were children,
about half of them were male (n = 173) and half were female (n
= 178). The mean age of males was 6.24 years and mean age of
females was 8.47 years. Sixty percent (n=213) of patients were in
0-6 age group, 8% (n=28) of patients were in 7-11 age group, 32
% (n=110) of patients were in 12-18 age group. Forty-six point
one percent (n = 162) were poisoned with medications. Among the
pharmaceuticals, paracetamol was the most commonly used agent
(14.8%). In non-pharmaceuticals, caustic/corrosive substances
(detergent, bleach, acetone etc.) were the most frequently used
agents (54%).
Conclusion: In this study, 80.3% of the cases were preventable
accidental poisoning. Regulations on child-resistant packaging
should come into force as soon as possible.

References

  • 1. Peden M, Oyegbite K, Ozanne-Smith J, et al. Poisoning. In: World Report on Child Injury Prevention. Geneva, Switzerland; 2008.
  • 2. Özcan N, İkincioğulları D. Ulusal zehi̇r danişma merkezi̇ 2008 yılı çalışma raporu özeti. Türk Hij Den Biyol Derg 2009; 66:29-58.
  • 3. Lamireau T, Llanas B, Kennedy A, et al. Epidemiology of poisoning in children: a 7-year survey in a paediatric emergency care unit. Eur J Emerg Med 2002;9:9-14.
  • 4. Kivistö JE, Arvola T, Parkkari J, Mattila VM. Paediatric poisonings treated in one Finnish main university hospital between 2002 and 2006. Acta Paediatr 2008;97:790-4. doi:wiley.com/10.1111/j.1651-2227.2008.00771.x
  • 5. Baker R, Orton E, Tata LJ, Kendrick D. Epidemiology of poisonings, fractures and burns among 0–24 year olds in England using linked health and mortality data. Eur J Public Health 2016;26:940–6. doi:10.1093/eurpub/ckw064
  • 6. Manouchehrifar M, Derakhshandeh N, Shojaee M, Sabzghabaei A, Farnaghi F. An epidemiologic study of pediatric poisoning; A six-month cross-sectional study. Emergency 2016;4:21-4.
  • 7. Karaci M, Yildiz N, Metin O, Ozcetin M. A retrospective study of childhood intoxication in the Zonguldak region. J Acad Emerg Med 2013;12:145-9.
  • 8. Kivistö JE, Parkkari J, Mattila VM, Hoppu K. Poisoning deaths among Finnish children from 1969 to 2003. Acta Paediatr 2009;98:1661-6. doi:10.1111/j.1651-2227.2009.01408.x
  • 9. Özdemir R, Bayrakcı B, Teküam Ö, Yalçın B, Kale G. Thirtythree- year experience on childhood poisoning. Turk J Pediatr 2012;54:251-9.
  • 10. Andiran N, Sarikayalar F. Pattern of acute poisonings in childhood in Ankara: what has changed in twenty years? Turk J Pediatr 2004;46:147-52.
  • 11. Akgül F, Er A, Çelebi Çelik F, et al. Retrospective Analysis of Childhood Poisoning. Turkish J Pediatr Emerg Intensive Care Med 2016;91-6.
  • 12. Schmertmann M, Williamson A, Black D. Unintentional poisoning in young children: does developmental stage predict the type of substance accessed and ingested? Child Care Health Dev 2014;40:50-9.
  • 13. Fergusson DM, Horwood LJ, Beautrais AL, Shannon FT. A controlled field trial of a poisoning prevention method. Pediatrics 1982;69:515-20.
  • 14. Anderson AC. Iron poisoning in children. Curr Opin Pediatr 1994;6:289-94.
  • 15. Ramos CL, Barros HM, Stein AT, Costa JS. Risk factors contributing to childhood poisoning. J Pediatr (Rio J) 2010;86:435-40.
  • 16. Sethi D, Towner E, Vincenten J, Gomez-Segui M, Racioppi F. Poisoning. In: European Report on Child Injury Prevention. Geneva, Switzerland; 2008.
  • 17. Hawton K, Bergen H, Waters K, et al. Epidemiology and nature of self-harm in children and adolescents: findings from the multicentre study of self-harm in England. Eur Child Adolesc Psychiatry 2012;21:369-77. doi:10.1007/ s00787-012-0269-6
  • 18. Prescott K, Stratton R, Freyer A, Hall I, Le Jeune I. Detailed analyses of self-poisoning episodes presenting to a large regional teaching hospital in the UK. Br J Clin Pharmacol 2009;68:260-8.
  • 19. Rodrigues Mendonça D, Menezes MS, Matos MAA, et al. Acute poisoning in children in Bahia, Brazil. Glob Pediatr Heal 2016;3:2333794X15623243. doi:10.1177/2333794X15623243
  • 20. Chowdhury AN, Banerjee S, Brahma A, Biswas MK. A study on mortality and morbidity pattern of acute childhood poisoning cases admitted in block primary health centres of Sundarban, West Bengal. Indian J Public Health 2008;52:40-2.
  • 21. Hoikka M, Liisanantti J, Dunder T. Acute poisoning in children under the age of six: a two-decade study of hospital admissions and trends. Acta Paediatr 2013;102:e329-33. doi:10.1111/apa.12238
  • 22. Akici N, Bayoğlu D, Gürbüz T, Önal E, Nuhoğlu Ç, Akici A. Alti yas ve altindaki çocuklarda ve alti yasindan büyük çocuklarda karsilasilan zehirlenmelerin arastirilmasi. Marmara Pharm J 2013;1:35-41.
  • 23. Eliaçık K, Kanık A, Karanfil Ö, Rastgel H. Bir üçüncü basamak hastane çocuk acil servisine başvuran zehirlenme vakalarının değerlendirilmesi. Symrna Tıp Derg 2012;1:41- 4.
  • 24. Mintegi S, Fernandez A, Alustiza J, et al. Emergency visits for childhood poisoning. Pediatr Emerg Care 2006;22:334-8.
  • 25. Yates KM. Accidental poisoning in New Zealand. Emerg Med 2003;15:244-9.
  • 26. Çam H, Kıray E, Taştan Y, Çerçi Özkan H. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Acil servisinde izlenen zehirlenme olguları. Türk Pediatr Arşivi 2003;38:233-9.
  • 27. Bükülmez A, Tahta EG, Şen TA, Alpay F. Çocuk Acil Servisine başvuran zehirlenme vakalarının değerlendirilmesi. Kocatepe Tıp Derg 2013;14:11-6.
  • 28. Poyraz Fındık OT, Akıcı N, Kırmızı Nİ, Tıplamaz S, Akıcı A. What should be the age limit for the children to access medications on their own?: Review. Turkiye Klin J Med Sci 2016;36:171-84.
  • 29. Öner N, İnan M, Vatansever Ü, et al. Trakya bölgesinde çocuklarda görülen zehirlenmeler. Türk Pediatr Arşivi 2004;39:25-30.
  • 30. Yin S. Malicious use of pharmaceuticals in children. J Pediatr 2010;157:832-6.
  • 31. Yin S. Malicious use of nonpharmaceuticals in children. Child Abuse Negl 2011;35:924-9. doi:10.1016/j.chiabu.2011.05.01
  • 32. Dinis-Oliveira RJ, Magalhães T. Children intoxications: what is abuse and what is not abuse. Trauma Violence Abuse 2013;14:113-32. doi:10.1177/1524838012470033
  • 33. Hines E. Child abuse by poisoning. Clin Pediatr Emerg Med [Internet]. 2016;17:296-301. doi:10.1016/j. cpem.2016.10.003
  • 34. Bateman DN. The epidemiology of poisoning. Medicine (Baltimore) 2007;35:537-9.
  • 35. Sandra Levy. CPSC to require child-resistant packaging on some household products. Drug Topics 2001;22.
There are 35 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Articles
Authors

Sıtkı Tıplamaz This is me

Erkin Kırkpınar This is me

Mehmet Akif İnanıcı This is me

Publication Date October 31, 2018
Published in Issue Year 2018 Volume: 31 Issue: 3

Cite

APA Tıplamaz, S., Kırkpınar, E., & İnanıcı, M. A. (2018). Acute poisoning in children; Evaluation of cases admitted to Marmara University Hospital in 2015. Marmara Medical Journal, 31(3), 120-125. https://doi.org/10.5472/marumj.474194
AMA Tıplamaz S, Kırkpınar E, İnanıcı MA. Acute poisoning in children; Evaluation of cases admitted to Marmara University Hospital in 2015. Marmara Med J. October 2018;31(3):120-125. doi:10.5472/marumj.474194
Chicago Tıplamaz, Sıtkı, Erkin Kırkpınar, and Mehmet Akif İnanıcı. “Acute Poisoning in Children; Evaluation of Cases Admitted to Marmara University Hospital in 2015”. Marmara Medical Journal 31, no. 3 (October 2018): 120-25. https://doi.org/10.5472/marumj.474194.
EndNote Tıplamaz S, Kırkpınar E, İnanıcı MA (October 1, 2018) Acute poisoning in children; Evaluation of cases admitted to Marmara University Hospital in 2015. Marmara Medical Journal 31 3 120–125.
IEEE S. Tıplamaz, E. Kırkpınar, and M. A. İnanıcı, “Acute poisoning in children; Evaluation of cases admitted to Marmara University Hospital in 2015”, Marmara Med J, vol. 31, no. 3, pp. 120–125, 2018, doi: 10.5472/marumj.474194.
ISNAD Tıplamaz, Sıtkı et al. “Acute Poisoning in Children; Evaluation of Cases Admitted to Marmara University Hospital in 2015”. Marmara Medical Journal 31/3 (October 2018), 120-125. https://doi.org/10.5472/marumj.474194.
JAMA Tıplamaz S, Kırkpınar E, İnanıcı MA. Acute poisoning in children; Evaluation of cases admitted to Marmara University Hospital in 2015. Marmara Med J. 2018;31:120–125.
MLA Tıplamaz, Sıtkı et al. “Acute Poisoning in Children; Evaluation of Cases Admitted to Marmara University Hospital in 2015”. Marmara Medical Journal, vol. 31, no. 3, 2018, pp. 120-5, doi:10.5472/marumj.474194.
Vancouver Tıplamaz S, Kırkpınar E, İnanıcı MA. Acute poisoning in children; Evaluation of cases admitted to Marmara University Hospital in 2015. Marmara Med J. 2018;31(3):120-5.