Incidence &amp; Patterns of Acute Poisoning Cases in an Emergency Department of a Tertiary Care Hospital in Chennai

Bamathy, B.; Punnagai, K.; Amritha, C. A.; Chellathai, Darling

doi:10.13005/bpj/1231

Cited by 12 publications

(10 citation statements)

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“…Suicidal attempts occurred in 60% of the studied patients. Similar results were noted by Arıkan et al (2014) in Turkey, Adinew et al (2017) in Ethiopia, and Bamathy et al (2017) in India. These results are in contrast to the 2019 annual report of AAPCC which noted suicidal poisoning in 18.9% of cases only, because the of intoxicated patients were children (Gummin et al, 2020).…”

Section: Discussionsupporting

confidence: 86%

A Triage for Disposition of Poisoned Patients with Cardiovascular Therapeutic Agents Presented to Poison Control Center of Ain Shams University Hospitals

Omar

Abdel-aal

Salem

2022

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Background: According to the 2016 annual report of the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH), toxicity of cardiovascular drugs represented 7.8% of all intoxicated cases. There is a great variability in the disposition of the poisoned patients with cardiovascular therapeutic agents between poison control centers depending on triage guidelines, compliance to these guidelines and the current practice. Objective: To compare the triage for disposition of intoxicated patients with cardiovascular therapeutic agents in PCC-ASUH with the American Association of Poison Control Centers (AAPCC). Methods: This study was a comparative cross-sectional study. Patients were divided into; retrospective group in which disposition was based on PSS and local PCC protocols, and a prospective observational group using the AAPCC guidelines. Results: Eight hundreds and six patients were included. Retrospectively, (37.2%) of the studied patients were observed in ER then discharged, (36.7%) were admitted to ICU, (8.37%) were admitted to inpatient unit, and (17.73%) were referred to another toxicology center. Prospectively, most of poisoned cases (57.39%) observed in ER then discharged, (11.78%) of patients were admitted to ICU, (27.82%) were admitted to inpatient unit, and (3.01%) were referred to another toxicology center, with no apparent adverse effects during follow up. Conclusion: Application of the AAPCC triage method can reduce the unnecessary admissions of poisoned patients with cardiovascular therapeutic agents through increasing the percent of observed patients in ER and reducing ICU admissions and the need for referral to other health care facility.

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Section: Discussionsupporting

confidence: 86%

A Triage for Disposition of Poisoned Patients with Cardiovascular Therapeutic Agents Presented to Poison Control Center of Ain Shams University Hospitals

Omar

Abdel-aal

Salem

2022

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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“…In the present study, if we exclude venomous snakebites, which accounted for 44.59% cases, corrosives (13.68%), sedatives (13.18%), and pesticides (12.16%) accounted for nearly equal proportion of the various types of poisonings encountered. Although pesticides and medicinal substances feature prominently in all poisoning series reported from Indian hospitals,[ 10 11 12 13 14 ] there are geographical variations in the relative incidence. For instance in a recent retrospective observational study on pattern of acute poisoning in an emergency department of a tertiary care hospital Karnataka,[ 15 ] pesticide poisoning accounted for 62.8% of the cases with snakebite coming next at 18.2%.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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.

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“…Acute poisoning is one of the commonest causes of hospitalization to the emergency department. [12] Acute poisoning is a result of deliberate or accidental or homicidal ingestion of harmful chemical substance into the body. Death due to poisoning has been known since time immemorial.…”

Section: Introductionmentioning

confidence: 99%

Mortality and morbidity associated with acute poisoning cases in north-east India: A retrospective study

Sharma

Neelanjana²,

Rawat

et al. 2019

J Family Med Prim Care

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Poisoning is a leading cause of morbidity and mortality in India and also a major health problem worldwide. Majority of the studies shows that insecticides and pesticides compounds are the most widely used agents for poisoning. Materials and Methods: A retrospective study was conducted to explore the hospital records of patients with acute poisoning cases. A structured proforma used to collect data regarding patients’ demographic information, incidence of poisoning, cause and type of poisoning, clinical presentation of patient, treatment, and prognosis. Data were analyzed with descriptive and inferential statistics. Results: A total 505 patient files with poisoning cases were admitted at emergency department. The mean age of the patients was 28.43 ± 14 years (range 1–84 years). In gender-wise ratio, male patients (59%) were higher than the females (39%). The occurrence of poisoning was high 209 (41.38%) in young adult with age of 21–30 years. The causes of poisoning were suicide in 63.96% of cases. In majority, 310 (61.38%) patients consumed insecticides or pesticides. About 51.1% patients were treated at locally available medical facilities and 48.9% cases were brought to tertiary care center directly for the treatment. About 258 (51.08%) patients treated with gastric lavage, and for 9 (1.8%) patients endotracheal intubation was performed. The average stay in the hospital was 12.53 ± 7.53 days and mortality was 42 (8.31%). Conclusion: This study highlights that the incidence of poisoning and its morbidity and mortality can be reduced by development and implementation of effective intervention at primary level by health care providers and strategies on preventive aspect.

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Incidence & Patterns of Acute Poisoning Cases in an Emergency Department of a Tertiary Care Hospital in Chennai

Cited by 12 publications

References 0 publications

A Triage for Disposition of Poisoned Patients with Cardiovascular Therapeutic Agents Presented to Poison Control Center of Ain Shams University Hospitals

A Triage for Disposition of Poisoned Patients with Cardiovascular Therapeutic Agents Presented to Poison Control Center of Ain Shams University Hospitals

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

Mortality and morbidity associated with acute poisoning cases in north-east India: A retrospective study

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