Hemani Ahuja1, Ashu Sara Mathai2, Aman Pannu3, Rohit Arora4. 1. Assistant Professor, Department of Anesthesia and Critical Care, Christian Medical College and Hospital , Ludhiana, Punjab, India . 2. Professor, Department of Anesthesia and Critical Care, Christian Medical College and Hospital , Ludhiana, Punjab, India . 3. Biostatistician, Department of Neurology, Christian Medical College and Hospital , Ludhiana, Punjab, India . 4. Consultant Eye Surgeon, Department of Ophthalmology, Dr Rohit Eye Care Hospital , Jagraon, India .
Abstract
BACKGROUND: Poisoning is becoming a real health care burden for developing countries like India. An improved knowledge of the patterns of poisonings, as well as the clinical course and outcomes of these cases can help to formulate better preventive and management strategies. AIM: To study the demographic and clinical profiles of patients admitted to the ICU with acute poisoning and to study the factors that predict their mortality. MATERIALS AND METHODS: Retrospective two years (September 1, 2010 to August 31, 2012) study of all consecutive patients admitted to the Intensive Care Unit (ICU) with acute poisoning at a tertiary care hospital in Northern India. RESULTS: Out of the 67 patients admitted to the ICU during the study period, the majority were young (median age 29 years) males (69%) who had consumed poison intentionally. Pesticides were the most commonly employed poison, notably organophosphorus compounds (22 patients, 32.8%) and aluminium phosphide (14 patients, 20.9%). While the overall mortality from all poisonings was low (18%), aluminium phosphide was highly toxic, with a mortality rate of 35%. The factors at ICU admission that were found to be associated with a significant risk of death were, high APACHE II and SOFA scores (p =0.0001 and p=0.006, respectively), as well as the need for mechanical ventilation and drugs for vasoactive support (p=0.012 and p= 0.0001, respectively). CONCLUSION: Use of pesticides for intentional poisoning continues to be rampant in Northern India, with many patients presenting in a critical condition to tertiary level hospitals. Pesticide regulations laws, educational awareness, counseling and poison information centers will help to curtail this public health problem.
BACKGROUND:Poisoning is becoming a real health care burden for developing countries like India. An improved knowledge of the patterns of poisonings, as well as the clinical course and outcomes of these cases can help to formulate better preventive and management strategies. AIM: To study the demographic and clinical profiles of patients admitted to the ICU with acute poisoning and to study the factors that predict their mortality. MATERIALS AND METHODS: Retrospective two years (September 1, 2010 to August 31, 2012) study of all consecutive patients admitted to the Intensive Care Unit (ICU) with acute poisoning at a tertiary care hospital in Northern India. RESULTS: Out of the 67 patients admitted to the ICU during the study period, the majority were young (median age 29 years) males (69%) who had consumed poison intentionally. Pesticides were the most commonly employed poison, notably organophosphorus compounds (22 patients, 32.8%) and aluminium phosphide (14 patients, 20.9%). While the overall mortality from all poisonings was low (18%), aluminium phosphide was highly toxic, with a mortality rate of 35%. The factors at ICU admission that were found to be associated with a significant risk of death were, high APACHE II and SOFA scores (p =0.0001 and p=0.006, respectively), as well as the need for mechanical ventilation and drugs for vasoactive support (p=0.012 and p= 0.0001, respectively). CONCLUSION: Use of pesticides for intentional poisoning continues to be rampant in Northern India, with many patients presenting in a critical condition to tertiary level hospitals. Pesticide regulations laws, educational awareness, counseling and poison information centers will help to curtail this public health problem.
Authors: Abeer A Sheta; Asmaa S El-Banna; Rania Abd Elmeguid; Hany E Mohamed; Nehad H Gad Journal: Environ Sci Pollut Res Int Date: 2019-09-13 Impact factor: 4.223
Authors: Toby Bonvoisin; Leah Utyasheva; Duleeka Knipe; David Gunnell; Michael Eddleston Journal: BMC Public Health Date: 2020-02-19 Impact factor: 3.295