A Retrospective Study of Childhood Intoxication in the Zonguldak Region

Abstract

Objective: Intoxication in childhood is an important health problem. The aims of this study are to determine the properties of intoxication cases that were treated and followed-up in our hospital and to be a guide for precautions. Material and Methods: Children who were hospitalised in the Bülent Ecevit University School of Medicine paediatric and paediatric intensive care units between January 2008 and October 2012 were included in the study. The necessary data were collected retrospectively by analysing the records of cases. Results: For the study, the files of 416 patients aged from 9 months to 16 years (mean 5.9±5.2 years) were scanned; 241 (57.9%) cases were female, 175 (42.1%) were male. Intoxication cases constituted 1.3% of all cases admitted to the children's emergency unit over a five year period. A high proportion (66.8%) of intoxication cases were between 1 and 6 years of age. In 75.2% of cases, the reason for intoxication was an accident. Ninety-four of the one hundred and three (91.3%) patients that were intoxicated as a result of a suicide attempt were girls and all of them were over 10 years of age. The most common substance for intoxication was drugs (71.7%), followed by corrosives and cleaning substances (6.5%). Antidepressant drugs were the most common drug group (20.4%) that caused intoxication. Only two (0.4%) patients died during this period. Conclusion: Poisoning shows a peak in two periods of childhood and adolescence in this study. We think that accidental ingestion in childhood may be prevented by parents' education and simple precautions in general. In addition, we recommend that families should demonstrate appropriate approaches, especially with regards to the psychology of adolescent girls, and, if necessary, get help from a specialist.

Çocuklarda akut zehirlenme; 2015 yılında Marmara Üniversitesi Hastanesi’ne başvuran olguların değerlendirilmesi

“…Approximately one-third (31.6%) of the poisoning cases admitted to the emergency department of our hospital were children. The majority of children with acute poisoning cases in our study were grouped in two age groups (0-6 (60%) and 12-18 (32%) age groups, respectively) in accordance with the literature [3][4][5][6][7][8]. According to the age distribution of genders, males in 0-6 years and females in 12-18 years were more prominent.…”

“…The most common forensic origin of poisoning in our study was accident with 100% in 0-6 age group according to hospital records and in the 12-18 age group it was suicide with 58.8%. Despite there are similar results [5,7] in studies conducted both in our country and in the world, Yin's study found that an average of 510 children under the age of seven intentionally poisoned in the USA between 2000-2008 [30,31]. It is also suggested that intentional intoxications had a much higher mortality, morbidity, and duration of exposure than accident-related intoxications [32,33].…”

“…This is consistent with other studies in adolescents. They found that girls had higher rates of suicides and boys had higher rates of substance abuse [5,7,8,17,18].…”

Update glance on childhood intoxication

“…Konya'da 2009 yılında yapılan bir çalışmada, beş yaş altı çocuk ölümlerinde kaza ile olan zehirlenmelerde karbonmonoksid, insektisidler, mantar ve temizlik maddeleri ve ilaçlar gözlenmiş-tir (31) . Trisiklik antidepresanlar, kolşisin ve opiyoid analjezikler mortalite riski yüksek ajanlardır (28,35,36) . Zehirlenme ile başvuran hastalar genellikle % 80-85 asemptomatik bulunmuştur (12)(13)(14) .…”

Çocuk yoğun bakım ünitesinde takip edilen zehirlenme olgularının demografik, epidemiyolojik ve klinik özellikleri

“…Son yıllarda ilaç zehirlenmelerinde alınan ilaçların değişkenlik gösterdiği; geçmiş yıllarda en sık ilaç zehirlenme nedeni olan parasetamol ve aspirin zehirlenmelerinin yerini artık antidepresan ve antipsikotik (SSS) ilaçların aldığı bildirilmektedir [30][31][32] . Ankara, Kayseri, Eskişehir ve Sakarya'dan bildirilen çalışmalarda ilaç zehirlenmelerinde en sık etken analjezik/antipiretik ajanlar iken; İstanbul, Edirne ve Zonguldak'tan yapılan çalışmalarda birinci sırada SSS ilaçları tespit edilmiştir 21,33,[34][35][36][37][38] . Even ve arkadaşlarının 18 ÇYBÜ'sinde izledikleri ilaç zehirlenmelerinde en sık nedenin antidepresanlar olduğunu, Fazen ve arkadaşları 39 ise barbütüratlar olduğunu bildirmişlerdir.…”