Kundavaram Paul Prabhakar Abhilash1, Jolly Chandran2, Sanjay Murugan3, Abel Samuel Rabbi N3, Jagadesha Selvan4, Anmol Jindal4, Karthik Gunasekaran5. 1. Professor (Emergency Medicine), Christian Medical College, Vellore, India. 2. Associate Physician (Paediatrics), PICU, Christian Medical College, Vellore, India. 3. Paramedic (Emergency Medicine), Christian Medical College, Vellore, India. 4. Junior Clinical Assistant (Emergency Medicine), Christian Medical College, Vellore, India. 5. Assistant Professor (General Medicine), Christian Medical College, Vellore, India.
Abstract
Background: Deliberate self-poisoning (DSP) is one of the leading causes of mortality and morbidity, with rodenticides being common compounds used by many victims. However, comprehensive data regarding the spectrum and outcome of rodenticide poisoning is scant. Method: This retrospective study was conducted in the Emergency Department (ED) of a large tertiary care hospital in South India between January 2017 and December 2018. All patients with deliberate consumption of rodenticides were included in the analysis. Results: During the study period, 1802 patients presented with DSP, among which 145 (8%) consumed rodenticide compounds. The mean (SD) age was 27.9 (10.7) years. Young adults (16-30 years) comprised 73% (106/145) of the study population. The majority (87%) were triaged as priority 2, while 10% were triaged as priority 1. Common rodenticide compounds consumed were yellow phosphorous (57%: 82/145), coumarins (12%: 17/145), zinc phosphide (19%: 27/145), and aluminum phosphide (1%: 1/145). A significant proportion of patients (18.6%) were under the influence of alcohol. Among the 73 males, 25 (34.2%) gave a history of co-consumption of alcohol. There was a history of previous DSP attempts in 6%. The majority (68%) of the patients were discharged alive from the hospital, and the in-hospital mortality rate was 9%. Age >30 years (adjusted OR: 2.2; 95% CI: 1.00-5.05; p value: 0.04) was an independent predictor of poor outcome. Conclusion: Rodenticide compound consumption for DSP is prevalent in young adults and is associated with significant mortality, especially with yellow phosphorous poisoning. The current trend in our country of the increasing use of highly fatal phosphorous compounds over the innocuous coumarin derivatives is a cause of grave concern.
Background: Deliberate self-poisoning (DSP) is one of the leading causes of mortality and morbidity, with rodenticides being common compounds used by many victims. However, comprehensive data regarding the spectrum and outcome of rodenticide poisoning is scant. Method: This retrospective study was conducted in the Emergency Department (ED) of a large tertiary care hospital in South India between January 2017 and December 2018. All patients with deliberate consumption of rodenticides were included in the analysis. Results: During the study period, 1802 patients presented with DSP, among which 145 (8%) consumed rodenticide compounds. The mean (SD) age was 27.9 (10.7) years. Young adults (16-30 years) comprised 73% (106/145) of the study population. The majority (87%) were triaged as priority 2, while 10% were triaged as priority 1. Common rodenticide compounds consumed were yellow phosphorous (57%: 82/145), coumarins (12%: 17/145), zinc phosphide (19%: 27/145), and aluminum phosphide (1%: 1/145). A significant proportion of patients (18.6%) were under the influence of alcohol. Among the 73 males, 25 (34.2%) gave a history of co-consumption of alcohol. There was a history of previous DSP attempts in 6%. The majority (68%) of the patients were discharged alive from the hospital, and the in-hospital mortality rate was 9%. Age >30 years (adjusted OR: 2.2; 95% CI: 1.00-5.05; p value: 0.04) was an independent predictor of poor outcome. Conclusion: Rodenticide compound consumption for DSP is prevalent in young adults and is associated with significant mortality, especially with yellow phosphorous poisoning. The current trend in our country of the increasing use of highly fatal phosphorous compounds over the innocuous coumarin derivatives is a cause of grave concern.
Authors: Debasis Sardar; Nitty Mathews; Joy Mammen; S C Nair; Shibu Jacob; Lalji Patel; Ajith Thomas; Shankar Jhanwar; Anand Sharma; Mousumi Sen; B Vijayalekshmi; K A Balasubramanian; K Subramani; Lovely Thomas; K P P Abhilash; Uday Zachariah; Elwyn Elias; Ashish Goel; C E Eapen Journal: Indian J Gastroenterol Date: 2020-02-19
Authors: Moses Kirubairaj Amos Jegaraj; Shubhanker Mitra; Sathish Kumar; Bagyalakshmi Selva; Manimaran Pushparaj; Bijesh Yadav; Abhilash Kundavaram Paul Prabhakar; Alex Reginald Journal: J Family Med Prim Care Date: 2016 Jan-Mar