患者中毒模式和与治疗结果相关的因素:肯尼亚基安布县医院案例研究

James Maina Githinji, Michael Mungoma, Kinara Fossa, Jesse Ngugi, Samwel Ondiek, Prabhjot Juttla, Alfred Owino Odongo, Moses Ndiritu, Magoma Mwancha-Kwasa
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摘要

背景:由于缺乏数据和中毒中心,世界范围内(主要是在发展中国家)不断上升的中毒发生率仍然不明确。本研究评估了导致肯尼亚Kiambu县不良结果的模式和因素。方法对2015年6月至2020年7月期间在9家医院就诊的中毒病例进行回顾性横断面研究。使用STATA版本13通过描述性、双变量和多变量逻辑回归分析收集的数据。结果基安布县中毒发生率最低,为3.2%。共研究了434例病例。大多数病例(85.5%)是由于急性暴露造成的,其中75%是故意的。使用的主要毒物为农药(61.1%)、石蜡(18.7%)、酒精(6.5%)和药品(4.4%)。3.9%不符合这些类别,5.5%仍然未知。入院时常见的表现为呕吐(35.3%)和意识不清(21.6%)。杀虫剂导致了72.0%的死亡。7.8%出现后遗症,17.6%完全但延迟恢复,6.0%死亡。病例总数最大的聚集性发生在锡卡镇副县。它还包含酒精和农药中毒的主要类别。男性(AOR为4.577,95% CI[1.244-16.842])与不良结局显著相关。不管中毒与否,78.8%的患者完全康复。由于缺乏标准化的中毒数据工具,患者记录缺乏反映患者接受的护理质量的重要信息,反映了缺乏收集、分析和利用中毒数据进行决策的结构。这项研究证实了在肯尼亚基安布县建立个人电脑的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Poisoning patterns and factors associated with treatment outcomes among patients: A case study of Kiambu county hospitals, Kenya
Background Rising poisoning incidences worldwide, primarily in developing countries, remain ambiguous due to paucity of data and poison centres. This study evaluates patterns and factors causing poor outcomes in Kiambu County, Kenya. Methods A records-based retrospective cross-sectional study of poisoning cases who presented to nine facilities between June 2015 and July 2020 was conducted. The data collected was analysed through descriptive, bivariate, and multivariate logistic regression using STATA version 13. Results Kiambu county has a minimum prevalence of poisoning of 3.2%. A total of 434 cases were studied. Most cases (85.5%) resulted from acute exposures, with 75% being intentional. Pesticides (61.1%), paraffin (18.7%), alcohol (6.5%), and pharmaceutical drugs (4.4%) were the primary poisons used. 3.9% didn't fit these categories, while 5.5% remained unknown. Common presentations at admission were vomiting (35.3%) and unconsciousness (21.6%). Pesticides were responsible for 72.0% of deaths. Sequelae occurred in 7.8%, full but delayed recovery in 17.6%, and 6.0% died. The largest cluster of total cases was found in Thika town sub-county. It also contained the primary clusters of alcohol and pesticide poisoning. Being male (AOR 4.577, 95% CI [1.244–16.842]) was significantly associated with adverse outcomes. Regardless of the poison, the majority 78.8% made a full recovery. Conclusion Due to the lack of standardized poisoning data tools, patient records lack vital information reflecting the quality of care that the patient received, reflecting a lack of structures to collect, analyse and utilise poisoning data for decision making. This study underpins the need for the establishment of a PC in Kiambu county, Kenya.
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