An observational study on acute poisoning in a tertiary care hospital in West Bengal, India

Abstract

Aim: Poisoning is a preventable cause of morbidity and mortality in India. We undertook a prospective observational study to estimate the incidence, nature, severity and treatment outcome trends of acute poisoning in a tertiary care hospital in eastern India. Methods: All patients, admitted during the study period with acute poisoning, drug overdose and envenomation, were enrolled. Food poisonings, animal bites, chronic drug or chemical poisonings were excluded. Medical records were scrutinized and caregiver interviews served as source documents. Demographics, nature and circumstances of the poisoning event, treatment offered, duration of hospitalization and outcome data were collected. Results: Over 18 months, 592 cases of acute poisoning, accounting for 0.63% of all hospital admissions, were enrolled. Males comprised 57.09%, median age was 22 years, and 52.20% hailed from rural area. Occupation-wise, excluding students and children, patients were mostly daily wage workers followed by housewives, service holders and farm workers. Snake bites comprised the largest category of cases at 264 (44.6%) followed by corrosives (13.68%), sedatives/hypnotics (13.18%), pesticides (12.16%), hydrocarbon oils (8.61%) and others. Majority (60.64%) of the cases was accidental and occurred at home (66.72%) and most (87.33%) were referred from primary health centers. Median time between event and arrival at primary care center was 1 hour while median time to arrival at the hospital was 11 hours. There were 89 deaths (mortality 15.03%) in the series. Male gender, rural residence, referred status and non-use of specific antidotes had negative impact on survival. Conclusion: This large prospective study from eastern India from a hospital perspective, has captured data not only on the incidence and nature of poisoning but also on treatment trends and mortality outcomes. Field studies conducted in the light of these results will clarify additional issues.

Profile and Outcome of Childhood Hydrocarbon Poisoning: An Observational Study

“…Critically sick patients (9.5%) were transferred to the pediatric intensive care unit (PICU). However, no deaths were reported, similar to previous studies [4][5][6][7].…”

“…Kerosene has been implicated as the most prevalent cause of accidental poisoning in the pediatric age group, as per studies conducted on children from various countries including India [5][6][7]. The major cause seems to be the incessant use of kerosene oil as fuel for cooking in rural and urban slum areas.…”

“…The major cause seems to be the incessant use of kerosene oil as fuel for cooking in rural and urban slum areas. Boys are predominantly affected, particularly under five years of age because of their exploratory nature and maximum activity [5][6][7][8]. There is a scarcity of studies describing the profile and outcome of children with hydrocarbon poisoning from the Eastern part of India.…”

Probabilistic model to predict the outcome in acute suicidal chemical poisoning cases from age and gender of patient and type of chemical poison consumed

“…Many congruent studies have also reported 0.3 to 0.6 % of emergency presentations due to poisons. 7,12,13 As in this study, most studies found maximum incidence of poisoning in age group less than 40 years and with men predominance, though, Ethiopia reports mixed results related to gender pre-Same model revealed that men have higher possibility for recovery and women are more prone to lethal outcome in acute chemical suicidal poisoning cases. Furthermore, it was also found that a randomly selected person has highest chances of cure if he/she is between 30-60 years of age and highest chances of death and LAMA if he/she is from the age group 60-75.…”

“…6 Though many studies regarding clinic-epidemiologic pattern of poisoning are available, only few of them explore the possible relationship between patient's basic characteristics, product used for poisoning and probable outcome. 7,8,9 Hence, this study was exclusively planned with following objective.…”