Acute Poisonings Admitted to a Tertiary Level Intensive Care Unit in Northern India: Patient Profile and Outcomes

Ahuja, Hemani

doi:10.7860/jcdr/2015/16008.6632

Cited by 43 publications

(61 citation statements)

References 16 publications

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“…In our study, men outnumbered women as victims of pesticides poisoning, which was similar in many other studies [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. The high proportion of poisonings among men may be attributed to a high degree of stress in financial and emotional matters, altercations with family members or friends and marital discord [7-11, 13, 14].…”

Section: Discussionsupporting

confidence: 90%

Assessment of pattern and outcomes of pesticides poisoning in a tertiary care hospital

Prashar

Ramesh

2018

Tropical Med Int Health

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Summary Objectives To assess the socio‐demographic profile, pattern and treatment outcomes of pesticides poisoning. Methods A prospective observational study was conducted at the department of emergency medicine of a South Indian tertiary care hospital for 1.5 years to study the pattern and outcomes of poisoning cases due to pesticides. Level of significance (P) <0.05 was considered as statistically significant. Results A total of 375 poisoning victims with intentional/accidental exposure to pesticides were followed up and documented. The male–female ratio was 1:0.32; mean age was 31.65 ± 13.10 years. 72% of cases were rural residents. Organophosphorus compounds were the most implicated pesticides. Mean Glasgow Comatose Score (GCS) of the patients was 12.22 ± 3.86. 80.3% of patients recovered while 6.4% died. About 13.3% patients were lost to follow‐up as they were discharged against medical advice (DAMA). Conclusion There was a statistical significance seen in the implication of pesticides for intentional poisoning with age, route of administration, area of residence and occupation of the victims. However, there was a strong association of the outcomes of poisoning with the toxic agent implicated for the poisoning.

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Section: Discussionsupporting

confidence: 90%

Assessment of pattern and outcomes of pesticides poisoning in a tertiary care hospital

Prashar

Ramesh

2018

Tropical Med Int Health

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“…Ahuja et al . found in their study of acute poisonings that among the cases of AlP poisoning, the mean APACHE II and SOFA scores at admission time were 10.6 ± 6.5 and 4.6 ± 4.0, respectively, which were in line with those of our study. Masson et al .…”

Section: Discussionsupporting

confidence: 93%

“…According to our results, systolic blood pressure of <92.5 mmHg, HCO 3 <12.9 mEq/L, UOP <1725 mL/day and GCS <14.5 predicted acute AlP poisoning mortality with good sensitivity and specificity. Very few studies have shown the best cut‐off point in laboratory tests to predict acute AlP‐poisoning mortality . Rehab et al .…”

Section: Discussionmentioning

confidence: 99%

“…Simplified Acute Physiology Score II (SAPS II), Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scoring systems are widely used in intensive care units (ICUs) to predict patient survival outcome. In the speciality of medical toxicology , the performance of these systems in the prediction of AlP‐poisoned patient outcome has been evaluated in only a few published studies .…”

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confidence: 99%

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Prognostic Factors in Acute Aluminium Phosphide Poisoning: A Risk‐Prediction Nomogram Approach

Farzaneh

Ghobadi

Akbarifard

et al. 2018

Basic Clin Pharma Tox

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Aluminium phosphide (AlP) is a toxic agent associated with a high mortality rate following acute exposure from various routes. The aim of this study was to determine the clinical and laboratory findings useful for predicting the medical outcome of AlP-poisoned patients using established scoring systems. This is a prospective study of AlP-poisoned patients from 2010 to 2015 in Ardabil, Iran. All patients that presented with a confirmed diagnosis of acute AlP poisoning in the study interval were included in the study. Clinical and laboratory data, using Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) and Simplified Acute Physiology Score II (SAPS II) scoring systems, were compared for their predictive value in determining differences between survived and non-survived patients. Univariate analysis (Mann-Whitney or t-test), multiple logistic regression analysis, receiver operating characteristic (ROC) curve analysis and the Pearson correlation test were performed using STATA/SE 13.0 and the Nomolog Software. A total of 68 AlP-poisoned patients with confirmed acute AlP poisoning were included for evaluation. Of these, 36 were non-survived. Multiple logistic regression analysis was performed using parameters and values derived from patient clinical and laboratory data, and revealed that four factors were significant for predicting mortality: Glasgow coma score (GCS); systolic blood pressure (SBP); urinary output (UOP); and serum HCO . A four-variable, risk-prediction nomogram was developed for identifying high-risk patients and predicting the risk of mortality. Study results showed that SBP of <92.5 mmHg (p = 0.006); HCO < 12.9 mEq/L (p = 0.01), UOP < 1725 mL/day (p = 0.04); and GCS < 14.5 (p = 0.003) were significant predictors of AlP mortality. Scoring systems analysis showed SAPS II score >24.5, APACHE II score >8.5 and SOFA score >7.5 were predictive of non-survival patients. The results of our study showed that SBP, GCS, UOP and serum HCO levels are the best prognostic factors for predicting mortality in AlP-poisoned patients. According to the area under the ROC curve of the APACHE II score, when compared with SOFA and SAPS II scores, the APACHE II score can more effectively discriminate between non-survivors and survived patients.

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“…Present study showed a mortality rate of 33% among aluminium phosphide poisoning cases which is lower the study conducted by Chugh which had a mortality rate of 77.2% and similar to the study by Hemani where the mortality rate was 35%. 10,11 The draw back in our studies were Metabolic score couldn't be calculated for every case as ABG analysis wasn't done for all the cases. It was performed in only 7 of the 12 among Zinc Phosphide poisoning, 11 of the 18 cases in Yellow Phosphorus poisoning and 15 of the 31 Aluminium Phosphide poisoning cases.…”

Section: Discussionmentioning

confidence: 98%

Clinical profile and outcome of rodenticide poisoning in patients admitted to a tertiary care teaching hospital in Mysore, Karnataka, India

et al. 2016

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Background: Rodenticide poisoning is of the major types of poisoning prevalent in India. However this broad category consists of different type of compounds with different mechanisms of toxicity and variable mortality rates. Methods: This study was performed on all cases of rodenticide poisonings admitted to a tertiary care hospital in Mysore between May 2014 and April 2015. Study consisted of 64 subjects. Results: 31 subjects had consumed aluminium phosphide, 18 had consumed Yellow Phosphorus and 12 had consumed Zinc Phosphide while 3 patients had consumed bromadiolone. There were 13 mortalities among the study group out of which 9 were in aluminium phosphide group while 4 were in the yellow phosphorus group. There were no mortalities in cases who had consumed zinc phosphide and bromodiolone. Conclusions: Aluminium phosphide was the most common compound rodenticide consumed and it was associated with increased mortality as compared to other Rodenticide poison.

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Acute Poisonings Admitted to a Tertiary Level Intensive Care Unit in Northern India: Patient Profile and Outcomes

Cited by 43 publications

References 16 publications

Assessment of pattern and outcomes of pesticides poisoning in a tertiary care hospital

Assessment of pattern and outcomes of pesticides poisoning in a tertiary care hospital

Prognostic Factors in Acute Aluminium Phosphide Poisoning: A Risk‐Prediction Nomogram Approach

Clinical profile and outcome of rodenticide poisoning in patients admitted to a tertiary care teaching hospital in Mysore, Karnataka, India

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