Clinical profile and outcome of patients with acute poisoning admitted in intensive care unit of tertiary care center in Eastern Nepal

Abstract

Background:Acute poisoning is a common health-care problem requiring admission in the intensive care unit (ICU) in the developing countries. The study was conducted to assess the epidemiological parameters of acute poisoning and factors affecting clinical course and outcome of the patients in ICU in the eastern part of Nepal.Methodology:This was a prospective observational study conducted at ICU of tertiary care hospital in the eastern part of Nepal for the duration of 2 years. All the acute poisoning cases admitted in the ICU were studied for epidemiological profiles, poisoning characteristics, and various clinical factors affecting the outcome of the patients.Results:Eighty-five patients with acute poisoning were included in the study. Suicidal attempt leading to acute poisoning was seen in majority of the young population. Majority of the poisoning was due to the organophosphorous compounds (43.5%). Patients with organophosphorous poisoning had a significantly longer duration of ICU stay (P = 0.020). The survival of the patients was significantly affected by age, duration of presentation to the hospital, Glasgow Coma Scale, Sequential Organ Failure Assessment score, need for mechanical ventilation, duration of ICU stay, hepatic failure, coagulopathy, and need for vasoactive drugs (P < 0.05). The independent predictors of mortality observed in the study were age, delayed presentation to the hospital, hepatic failure, and need for mechanical ventilation.Conclusion:Organophosphorous poisoning was the most common acute poisoning in young population leading to the ICU admission. Older age, delayed initiation of the resuscitative measures, need for mechanical ventilation, and hepatic failure significantly affected the mortality.

Clinical patterns and outcome of acute poisoning at a tertiary care hospital in coastal Karnataka, India

“…20 Altered sensorium was present in a significant number of patients (38.5%) which is in accordance with a study done in Pakistan. 11 Mortality was seen in 13 patients (7.7%) which is comparable to a study done in Kerala and lower compared to another study done by Lalit et al 14,15 and Ahuja et al 21 The lower mortality in this study could be due to timely arrival to hospital, lesser number of cases of pesticide poisoning and early treatment. Statistically significant variables contributing to mortality included male gender, nature of the poison (OP compound), presence of ARDS and renal failure.…”

“…As agriculture being the main occupation in India, OP compounds are easily available and many studies have found pesticides to be the commonest poison. 6,7,15 In contrast, this study showed drugs to be the most common agents of poisoning. This could be due to higher percentage of patients having psychiatric illness as compared to other studies and antipsychotics were among the common drugs consumed.…”

“…13 Majority of the affected population was in the age group of 21-30 years (46.7%) which is comparable with a recent study done South India and also a study done in Nepal by Lalit Kumar. 14,15 The reason for this young age group to indulge in self poisoning could be due to the fact that this age group has a lot of personal and social stress and responsibilities related to career goals, studies, love affairs and parental expectations.…”

“…15 This can be explained by the fact that females are easily affected mentally and emotionally by factors such as domestic violence and love affair failures. 16,17 This study showed that most of the patients were literates which is in accordance with study done by Lalit kumar et al 15 The poisoning was common among married population which is in accordance with other studies. 18,19 The reason could be due to the reaction to marital conflicts, increased stress and responsibilities in the married population.…”

Spectrum of Unnatural Deaths in Palpa, Nepal: Autopsy Based Study

“…The present study conducted over a period of one year reports 15 cases of death due to drowning.Although poisoning is one of the commonest methods of commi ng deliberate self-harm, advances in treatment of the vic m with intensive care support might have declined the fatal outcome. A hospital based study of poisoning from eastern Nepal observed 17.6% mortality out of 85 cases of21 poisoning in two years. A descrip ve epidemiological study on insec cide poisoning from central part of Nepal observed 439 cases of acute pes cide poisonings during a 9 month 22 study of which 3.8% succumbed to death.…”