Çocuklarda akut zehirlenmelerde farklılıklar:Tek merkez deneyimi
Yıl 2021,
, 451 - 460, 10.09.2021
Yelda Türkmenoğlu
,
Alper Kaçar
,
Belen Terlemez
Gizem Güvener
Pınar Bütün
,
Seda Yolgiden Guren
,
Berna Akşahin
Ümit Sarıtaş
,
Ahmet Irdem
,
Faruk Beser
Öz
Giriş: Çocuklukta akut zehirlenmelerin özellikleri aynı toplumlarda zaman içinde değişebilmektedir. Bu çalışmanın amacı aynı merkeze farklı zamanlarda başvuran zehirlenme olgularının demografik özelliklerini karşılaştırmaktır.Yöntemler: Bu çalışma merkezimize 2010 ve 2016 yıllarında zehirlenme şikayetiyle başvuran 0-16 yaş arasındaki çocuklar arasında yapıldı. Zehirlenme olgularının demografik özellikleri acil kayıtlarından değerlendirildi ve her iki yılın bulguları birbiriyle karşılaştırıldı.Bulgular: Grup 2010’da 404, Grup 2016’da ise 398 olgunun yaş ortalaması sırasıyla 6,5±5.1yaş ve 4,7±4.6 yaş idi (p=0.001). İlaç zehirlenmeleri her iki grupta ilk sıradaydı, Grup 2010’da %61.6 ve Grup 2016’da %49.7 sıklığında idi (p=0.001). Gazlarla olan zehirlenmeler Grup 2010’da %19.2 ve Grup 2016’da %10.1 oranında gözlendi (p=0.0001). Grup 2010 ile Grup 2016 karşılaştırıldığında Grup 2010'da %13.8 Grup 2016’da ise %29.4 sıklığında korroziv maddelerle zehirlenme gözlendi. Kaza sonucu zehirlenme olguları ise Grup 2010'da % 77.3 iken Grup 2016'da % 81.9 idi (p = 0,001). Sonuçlar: İlaç ve gaz ile olan zehirlenmelerde azalma, ancak kostik maddelerle olan zehirlenmelerde artış görülmüştür. Kaza ile olan zehirlenmelerdeki artışın toplumun bu konuda farkındalığının artması ve eğitilmesi ile önlenebileceği düşünülmektedir.
Teşekkür
Çağla Saırtürk'e istatistik destepi için teşekkür ederiz
Kaynakça
- 1. Peden M, Oyegbite K, Ozanne-Smith J, Branche C, Rahman A.K.M.F, Rivara F. World Health Organization; Geneva: 2008. World report on child injury prevention. Available from:https://www.ncbi.nlm.nih.gov/books/NBK310641/ accessed: 19.10. 2020
- 2. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Osterthaler KM, Banner W, et al. 2017 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 35th Annual Report. Clin Toxicol (Phila). 2018; 56 (12): 1213-1415. doi: 10.1080/15563650.2018.1533727
- 3. Mintegi S, Azkunaga B, Prego J, Qureshi N, Dalziel SR, Arana-Arri E, et al. Pediatric Emergency Research Networks (PERN) Poisoning Working Group International Epidemiological Differences in Acute Poisonings in Pediatric Emergency Departments. Pediatr Emerg Care. 2019;35(1):50-57. doi: 10.1097/PEC.0000000000001031
- 4. Berta GN, Di Scipio F, Bosetti FM, Mognetti B, Romano F, Carere ME, et al. Childhood acute poisoning in the Italian North-West area: a six-year retrospective study. Ital J Pediatr. 2020 11;46(1):83. doi: 10.1186/s13052-020-00845-0
- 5. Lee J, Fan NC, Yao TC, Hsia SH, Lee EP, Huang JL, et al. Clinical Spectrum of Acute Poisoning in Children Admitted to the Pediatric Emergency Department. Pediatr Neonatol. 2019;60 (1):59-67. doi: 10.1016/j.pedneo.2018.04.00
- 6. Moon J, Chun B, Cho Y, Lee S, Jung E. Characteristics of Emergency Department Presentations of Pediatric Poisoning Between 2011 and 2016: A Retrospective Observational Study in South Korea. Pediatr Emerg Care. 2018 14. doi: 10.1097/PEC.0000000000001668
- 7. Tsalkidis A, Vaos G, Gardikis S, Kambouri K, Tripsianis G, Mantadakis E, et al. Acute poisoning among children admitted to a regional university hospital in Northern Greece. Cent Eur J Public Health. 2010;18(4):219-223.
- 8. Andiran N, Sarikayalar F. Pattern of acute poisonings in childhood in Ankara: what has changed in twenty years? Turk J Pediatr. 2004;46(2):147-152.
- 9. Ozdemir R, Bayrakci B, Tekşam O, Yalçin B, Kale G. Thirty-three-year experience on childhood poisoning. Turk J Pediatr. 2012;54 (3):251-259.
- 10. Türkmenoğlu Y, Berna Gümüşoğlu BA, Sarıtaş Ü, Yılmaz B, Arat C, Şafak E, et al. Update Glance on Childhood Intoxication. Okmeydanı Tıp Dergisi 2015;31(2):82-91. doi:10.5222/otd.2015.082
- 11. Sahin S, Carman KB, Dinleyici EC. Acute poisoning in children; data of a pediatric emergency unit. Iran J Pediatr. 2011;21(4):479-484.
- 12. Alghadeer S, Alrohaimi M, Althiban A, Kalagi NA, Balkhi B, Khan AA. The patterns of children poisoning cases in community teaching hospital in Riyadh, Saudi Arabia. Saudi Pharm J. 2018;26 (1): 93-97. doi: 10.1016/j.jsps.2017.10.007
- 13. Santiago P, Bilbao N, Martinez-Indart L, Mintegi S, Azkunaga B; Intoxications Working Group of the Spanish Society of Pediatric Emergencies. Epidemiology of acute pediatric poisonings in Spain: a prospective multicenter study from the Spanish Society of Pediatric Emergency Medicine. Eur J Emerg Med. 2020;27(4):284-289. doi: 10.1097/MEJ.0000000000000661
- 14. Bell JC, Bentley JP, Downie C, Cairns R, Buckley NA, Katelaris A, et al. Accidental pharmacological poisonings in young children: population-based study in three settings. Clin Toxicol (Phila). 2018;56(8):782-789. doi: 1.1080/15563650.2017
- 15. Bacha T, Tilahun B. A cross-sectional study of children with acute poisoning: A three-year retrospective analysis. World J Emerg Med. 2015;6(4):265-269. doi: 10.5847/ wjemj.1920-8642.2015.04.003
- 16. Balcı AS, Kolaç N, Kocabaş S, Yaşar S, Gürsoy T. The effect of personal safety training program for pre school children. TJFMPC. 2020; 14(3): 414 – 419.
- 17. Ulseth ET, Freuchen A, Köpp UMS. Acute poisoning among children and adolescents in southern Norway. Tidsskr Nor Laegeforen. 2019 23;139(13). doi: 10.4045/tidsskr.17.1116
- 18. Mathias TL, Guidoni CM, Girotto E. Trends of drug-related poisoning cases attended to at a poison control center. Rev Bras Epidemiol. 2019 1;22: e190018. doi: 10.1590/1980-549720190018
- 19. Ram P, Kanchan T, Unnikrishnan B. Pattern of acute poisonings in children below 15 years--a study from Mangalore, South India. J Forensic Leg Med. 2014; 5:26-9. doi: 10.1016/j.jflm.2014.04.001
- 20. Kesaplı M, Çelik A, Isı I. Characteristic Features of Childhood and Adolescent Poisonings, in the Mediterranean Region over 6 Years. Iran J Public Health. 2018;47 (11):1667-1674.
- 21. Carreiro S, Miller S, Wang B, Wax P, Campleman S, Manini AF. Clinical predictors of adverse cardiovascular events for acute pediatric drug exposures. Clin Toxicol (Phila). 2020;58(3):183-189. doi: 10.1080/15563650.2019.1634272
- 22. Nistor N, Frasinariu OE, Rugină A, Ciomaga IM, Jităreanu C, Ştreangă V Epidemiological study on accidental poisonings in children from northeast Romania. Medicine (Baltimore). 2018; 97(29): e11469. doi: 10.1097/MD.0000000000011469
- 23. Powers KS. Diagnosis and management of common toxic ingestions and inhalations. Pediatr Annals 2000;29: 330-342.
- 24. Maior MDCLS, Osorio-de-Castro CGS, Andrade CLT. Demographics, deaths and severity indicators in hospitalizations due to drug poisoning among children under age five in Brazil. Rev Bras Epidemiol. 2020 (9);23: e200016. doi: 10.1590/1980-549720200016
- 25. Duramaz BB, Yıldırım HM, Kıhtır HS, Yeşilbaş O, Şevketoğlu E. Evaluation of forensic cases admitted to pediatric intensive care unit. Turk Pediatri Ars. 2015; 50 (3): 145-150.doi: 10.5152/TurkPediatriArs.2015.2399
Differences in acute childhood poisoning: A single center experience
Yıl 2021,
, 451 - 460, 10.09.2021
Yelda Türkmenoğlu
,
Alper Kaçar
,
Belen Terlemez
Gizem Güvener
Pınar Bütün
,
Seda Yolgiden Guren
,
Berna Akşahin
Ümit Sarıtaş
,
Ahmet Irdem
,
Faruk Beser
Öz
Introduction: Characteristics of acute childhood poisonings may change over time in the same populations. The aim of this study is to compare the demographic characteristics of poisoning children presenting to the same center at different times.
Methods: This study was conducted among children aged 0-16 years who presented with the complaint of poisoning to our center in 2010 and 2016.The demographic characteristics of the poisoning cases were evaluated from the emergency records and the findings of both years were compared with each other. Results: The mean age of 404 cases in Group 2010 and 398 cases in Group 2016 were 6.5 ± 5.1 years and 4.7 ± 4.6 years, respectively (p = 0.001). Drug poisonings were in the first place in both groups, the group was 61.6% in 2010 and 49.7% in 2016 (p = 0.001). Gas poisoning was observed at a rate of 19.2% in the Group 2010 and 10.1% in the Group 2016 (p = 0.0001). When Group 2010 and Group 2016 were compared, poisoning with corrosive substances was observed with a frequency of 13.8% in Group 2010 and 29.4% in Group 2016. The rate of accidental poisoning cases was 77.3 % in Group 2010 and 81.9 % in Group 2016 (p = 0.001). Conclusions: There was a decrease in drug and gas intoxications, but an increase in intoxications with caustic substances. It is thought that the increase in accidental poisoning can be prevented by increasing the awareness and education of the society on this issue.
Kaynakça
- 1. Peden M, Oyegbite K, Ozanne-Smith J, Branche C, Rahman A.K.M.F, Rivara F. World Health Organization; Geneva: 2008. World report on child injury prevention. Available from:https://www.ncbi.nlm.nih.gov/books/NBK310641/ accessed: 19.10. 2020
- 2. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Osterthaler KM, Banner W, et al. 2017 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 35th Annual Report. Clin Toxicol (Phila). 2018; 56 (12): 1213-1415. doi: 10.1080/15563650.2018.1533727
- 3. Mintegi S, Azkunaga B, Prego J, Qureshi N, Dalziel SR, Arana-Arri E, et al. Pediatric Emergency Research Networks (PERN) Poisoning Working Group International Epidemiological Differences in Acute Poisonings in Pediatric Emergency Departments. Pediatr Emerg Care. 2019;35(1):50-57. doi: 10.1097/PEC.0000000000001031
- 4. Berta GN, Di Scipio F, Bosetti FM, Mognetti B, Romano F, Carere ME, et al. Childhood acute poisoning in the Italian North-West area: a six-year retrospective study. Ital J Pediatr. 2020 11;46(1):83. doi: 10.1186/s13052-020-00845-0
- 5. Lee J, Fan NC, Yao TC, Hsia SH, Lee EP, Huang JL, et al. Clinical Spectrum of Acute Poisoning in Children Admitted to the Pediatric Emergency Department. Pediatr Neonatol. 2019;60 (1):59-67. doi: 10.1016/j.pedneo.2018.04.00
- 6. Moon J, Chun B, Cho Y, Lee S, Jung E. Characteristics of Emergency Department Presentations of Pediatric Poisoning Between 2011 and 2016: A Retrospective Observational Study in South Korea. Pediatr Emerg Care. 2018 14. doi: 10.1097/PEC.0000000000001668
- 7. Tsalkidis A, Vaos G, Gardikis S, Kambouri K, Tripsianis G, Mantadakis E, et al. Acute poisoning among children admitted to a regional university hospital in Northern Greece. Cent Eur J Public Health. 2010;18(4):219-223.
- 8. Andiran N, Sarikayalar F. Pattern of acute poisonings in childhood in Ankara: what has changed in twenty years? Turk J Pediatr. 2004;46(2):147-152.
- 9. Ozdemir R, Bayrakci B, Tekşam O, Yalçin B, Kale G. Thirty-three-year experience on childhood poisoning. Turk J Pediatr. 2012;54 (3):251-259.
- 10. Türkmenoğlu Y, Berna Gümüşoğlu BA, Sarıtaş Ü, Yılmaz B, Arat C, Şafak E, et al. Update Glance on Childhood Intoxication. Okmeydanı Tıp Dergisi 2015;31(2):82-91. doi:10.5222/otd.2015.082
- 11. Sahin S, Carman KB, Dinleyici EC. Acute poisoning in children; data of a pediatric emergency unit. Iran J Pediatr. 2011;21(4):479-484.
- 12. Alghadeer S, Alrohaimi M, Althiban A, Kalagi NA, Balkhi B, Khan AA. The patterns of children poisoning cases in community teaching hospital in Riyadh, Saudi Arabia. Saudi Pharm J. 2018;26 (1): 93-97. doi: 10.1016/j.jsps.2017.10.007
- 13. Santiago P, Bilbao N, Martinez-Indart L, Mintegi S, Azkunaga B; Intoxications Working Group of the Spanish Society of Pediatric Emergencies. Epidemiology of acute pediatric poisonings in Spain: a prospective multicenter study from the Spanish Society of Pediatric Emergency Medicine. Eur J Emerg Med. 2020;27(4):284-289. doi: 10.1097/MEJ.0000000000000661
- 14. Bell JC, Bentley JP, Downie C, Cairns R, Buckley NA, Katelaris A, et al. Accidental pharmacological poisonings in young children: population-based study in three settings. Clin Toxicol (Phila). 2018;56(8):782-789. doi: 1.1080/15563650.2017
- 15. Bacha T, Tilahun B. A cross-sectional study of children with acute poisoning: A three-year retrospective analysis. World J Emerg Med. 2015;6(4):265-269. doi: 10.5847/ wjemj.1920-8642.2015.04.003
- 16. Balcı AS, Kolaç N, Kocabaş S, Yaşar S, Gürsoy T. The effect of personal safety training program for pre school children. TJFMPC. 2020; 14(3): 414 – 419.
- 17. Ulseth ET, Freuchen A, Köpp UMS. Acute poisoning among children and adolescents in southern Norway. Tidsskr Nor Laegeforen. 2019 23;139(13). doi: 10.4045/tidsskr.17.1116
- 18. Mathias TL, Guidoni CM, Girotto E. Trends of drug-related poisoning cases attended to at a poison control center. Rev Bras Epidemiol. 2019 1;22: e190018. doi: 10.1590/1980-549720190018
- 19. Ram P, Kanchan T, Unnikrishnan B. Pattern of acute poisonings in children below 15 years--a study from Mangalore, South India. J Forensic Leg Med. 2014; 5:26-9. doi: 10.1016/j.jflm.2014.04.001
- 20. Kesaplı M, Çelik A, Isı I. Characteristic Features of Childhood and Adolescent Poisonings, in the Mediterranean Region over 6 Years. Iran J Public Health. 2018;47 (11):1667-1674.
- 21. Carreiro S, Miller S, Wang B, Wax P, Campleman S, Manini AF. Clinical predictors of adverse cardiovascular events for acute pediatric drug exposures. Clin Toxicol (Phila). 2020;58(3):183-189. doi: 10.1080/15563650.2019.1634272
- 22. Nistor N, Frasinariu OE, Rugină A, Ciomaga IM, Jităreanu C, Ştreangă V Epidemiological study on accidental poisonings in children from northeast Romania. Medicine (Baltimore). 2018; 97(29): e11469. doi: 10.1097/MD.0000000000011469
- 23. Powers KS. Diagnosis and management of common toxic ingestions and inhalations. Pediatr Annals 2000;29: 330-342.
- 24. Maior MDCLS, Osorio-de-Castro CGS, Andrade CLT. Demographics, deaths and severity indicators in hospitalizations due to drug poisoning among children under age five in Brazil. Rev Bras Epidemiol. 2020 (9);23: e200016. doi: 10.1590/1980-549720200016
- 25. Duramaz BB, Yıldırım HM, Kıhtır HS, Yeşilbaş O, Şevketoğlu E. Evaluation of forensic cases admitted to pediatric intensive care unit. Turk Pediatri Ars. 2015; 50 (3): 145-150.doi: 10.5152/TurkPediatriArs.2015.2399