{"title":"印度北部急性中毒的变化谱:一项基于医院的描述性研究。","authors":"Ashok Kumar Pannu, Ashish Bhalla, Vitla Vamshi, Manish Kumar Upadhyay, Navneet Sharma, Susheel Kumar","doi":"10.4103/2452-2473.357627","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Evaluating local trends and continued monitoring of patterns of acute poisoning are essential for prompt recognition of the toxidromes, the establishment of immediate treatment facilities (e.g., antidote availability), and effective preventive strategies (e.g., governmental regulation on hazardous substances marketing). We aimed to describe the prevalence of the various types of poisoning and associated case fatality in our academic hospital in North India.</p><p><strong>Methods: </strong>A prospective observational descriptive study was conducted, enrolling patients aged ≥13 years with acute poisoning for 17 months from December 2016 to December 2017 and from September 2019 to December 2019, for a total of 17 months.</p><p><strong>Results: </strong>Four hundred and two patients were enrolled (median age 28 years; 63.2% males). Majority of the acute poisoning cases resulted from ingestion (<i>n</i> = 391, 97.3%) and the primary intention was most commonly self-harm (<i>n</i> = 314, 78.1%). The major types of poisoning were pesticide (<i>n</i> = 264, 65.7%), drug overdose (<i>n</i> = 77, 19.2%), and corrosive ingestion (<i>n</i> = 31, 7.7%). Pesticides included insecticides (<i>n</i> = 146, 36.3%; cholinesterase inhibitors, <i>n</i> = 91), fungicides (<i>n</i> = 76, 18.9%; all aluminum phosphide), herbicides (<i>n</i> = 22, 5.5%; paraquat, <i>n</i> = 19), and rodenticides (<i>n</i> = 20, 5.0%; coumarin-derived substances, <i>n</i> = 12). Benzodiazepines (<i>n</i> = 33) and opioids (<i>n</i> = 25) were frequent causes of drug overdose. 95.3% (<i>n</i> = 379) received preliminary treatment at the previous health-care center, including gastric lavage (<i>n</i> = 239) and antidotes (<i>n</i> = 73). In-hospital case fatality rate was 17.3% (<i>n</i> = 58).</p><p><strong>Conclusion: </strong>Herbicide ingestion and opioid overdose are emerging threats with a gradual decline in organophosphate and aluminum phosphide poisoning. Despite improving management of acute poisoning, the overall case fatality rate remains substantial.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/61/TJEM-22-192.PMC9639736.pdf","citationCount":"5","resultStr":"{\"title\":\"Changing spectrum of acute poisoning in North India: A hospital-based descriptive study.\",\"authors\":\"Ashok Kumar Pannu, Ashish Bhalla, Vitla Vamshi, Manish Kumar Upadhyay, Navneet Sharma, Susheel Kumar\",\"doi\":\"10.4103/2452-2473.357627\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Evaluating local trends and continued monitoring of patterns of acute poisoning are essential for prompt recognition of the toxidromes, the establishment of immediate treatment facilities (e.g., antidote availability), and effective preventive strategies (e.g., governmental regulation on hazardous substances marketing). We aimed to describe the prevalence of the various types of poisoning and associated case fatality in our academic hospital in North India.</p><p><strong>Methods: </strong>A prospective observational descriptive study was conducted, enrolling patients aged ≥13 years with acute poisoning for 17 months from December 2016 to December 2017 and from September 2019 to December 2019, for a total of 17 months.</p><p><strong>Results: </strong>Four hundred and two patients were enrolled (median age 28 years; 63.2% males). Majority of the acute poisoning cases resulted from ingestion (<i>n</i> = 391, 97.3%) and the primary intention was most commonly self-harm (<i>n</i> = 314, 78.1%). The major types of poisoning were pesticide (<i>n</i> = 264, 65.7%), drug overdose (<i>n</i> = 77, 19.2%), and corrosive ingestion (<i>n</i> = 31, 7.7%). Pesticides included insecticides (<i>n</i> = 146, 36.3%; cholinesterase inhibitors, <i>n</i> = 91), fungicides (<i>n</i> = 76, 18.9%; all aluminum phosphide), herbicides (<i>n</i> = 22, 5.5%; paraquat, <i>n</i> = 19), and rodenticides (<i>n</i> = 20, 5.0%; coumarin-derived substances, <i>n</i> = 12). Benzodiazepines (<i>n</i> = 33) and opioids (<i>n</i> = 25) were frequent causes of drug overdose. 95.3% (<i>n</i> = 379) received preliminary treatment at the previous health-care center, including gastric lavage (<i>n</i> = 239) and antidotes (<i>n</i> = 73). In-hospital case fatality rate was 17.3% (<i>n</i> = 58).</p><p><strong>Conclusion: </strong>Herbicide ingestion and opioid overdose are emerging threats with a gradual decline in organophosphate and aluminum phosphide poisoning. Despite improving management of acute poisoning, the overall case fatality rate remains substantial.</p>\",\"PeriodicalId\":46536,\"journal\":{\"name\":\"Turkish Journal of Emergency Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2022-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/61/TJEM-22-192.PMC9639736.pdf\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Turkish Journal of Emergency Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/2452-2473.357627\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Turkish Journal of Emergency Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/2452-2473.357627","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
Changing spectrum of acute poisoning in North India: A hospital-based descriptive study.
Objectives: Evaluating local trends and continued monitoring of patterns of acute poisoning are essential for prompt recognition of the toxidromes, the establishment of immediate treatment facilities (e.g., antidote availability), and effective preventive strategies (e.g., governmental regulation on hazardous substances marketing). We aimed to describe the prevalence of the various types of poisoning and associated case fatality in our academic hospital in North India.
Methods: A prospective observational descriptive study was conducted, enrolling patients aged ≥13 years with acute poisoning for 17 months from December 2016 to December 2017 and from September 2019 to December 2019, for a total of 17 months.
Results: Four hundred and two patients were enrolled (median age 28 years; 63.2% males). Majority of the acute poisoning cases resulted from ingestion (n = 391, 97.3%) and the primary intention was most commonly self-harm (n = 314, 78.1%). The major types of poisoning were pesticide (n = 264, 65.7%), drug overdose (n = 77, 19.2%), and corrosive ingestion (n = 31, 7.7%). Pesticides included insecticides (n = 146, 36.3%; cholinesterase inhibitors, n = 91), fungicides (n = 76, 18.9%; all aluminum phosphide), herbicides (n = 22, 5.5%; paraquat, n = 19), and rodenticides (n = 20, 5.0%; coumarin-derived substances, n = 12). Benzodiazepines (n = 33) and opioids (n = 25) were frequent causes of drug overdose. 95.3% (n = 379) received preliminary treatment at the previous health-care center, including gastric lavage (n = 239) and antidotes (n = 73). In-hospital case fatality rate was 17.3% (n = 58).
Conclusion: Herbicide ingestion and opioid overdose are emerging threats with a gradual decline in organophosphate and aluminum phosphide poisoning. Despite improving management of acute poisoning, the overall case fatality rate remains substantial.
期刊介绍：
The Turkish Journal of Emergency Medicine (Turk J Emerg Med) is an International, peer-reviewed, open-access journal that publishes clinical and experimental trials, case reports, invited reviews, case images, letters to the Editor, and interesting research conducted in all fields of Emergency Medicine. The Journal is the official scientific publication of the Emergency Medicine Association of Turkey (EMAT) and is printed four times a year, in January, April, July and October. The language of the journal is English. The Journal is based on independent and unbiased double-blinded peer-reviewed principles. Only unpublished papers that are not under review for publication elsewhere can be submitted. The authors are responsible for the scientific content of the material to be published. The Turkish Journal of Emergency Medicine reserves the right to request any research materials on which the paper is based. The Editorial Board of the Turkish Journal of Emergency Medicine and the Publisher adheres to the principles of the International Council of Medical Journal Editors, the World Association of Medical Editors, the Council of Science Editors, the Committee on Publication Ethics, the US National Library of Medicine, the US Office of Research Integrity, the European Association of Science Editors, and the International Society of Managing and Technical Editors.
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