Hong Kong Poison Information Centre: Annual report 2018

Chow, Tin Yat Anthony; Chan, Chung-hong; Ng, Sze Hong; Tse, ML

doi:10.1177/1024907919893469

Cited by 4 publications

(6 citation statements)

References 23 publications

(49 reference statements)

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“…The age and gender distribution, and routes of exposure were grossly similar when compared with our previous reports and overseas data 1 , 2 . This year, the previously observed rising trend of poisoning in the teenage group (13–19 years) continued, with the proportion increasing from 6.3% in 2016, 7.6% in 2017, 8.9% in 2018 to 10.5% this year.…”

Section: Discussionsupporting

confidence: 84%

“…Concerning the method of decontamination, single-dose AC remained the most common, which is consistent with our local experience and overseas poison centre data. 1,2…”

Section: Discussionmentioning

confidence: 99%

“…Concerning the method of decontamination, single-dose AC remained the most common, which is consistent with our local experience and overseas poison centre data. 1,2 Among all types of antidotes, NAC, benzodiazepines and hyperbaric oxygen (HBO) were the three most frequently used. NAC has been the most common antidote in all of our previous annual reports except in 2008.…”

Section: Discussionmentioning

confidence: 99%

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Hong Kong Poison Information Centre: Annual report 2019

Chow

Chan

et al. 2022

Hong Kong j. emerg. med.

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Background: The Hong Kong Poison Information Centre (HKPIC) provides consultation service to health care professionals and collect epidemiological data on poisoning in Hong Kong since 2005. Objective: To report and analyse the data of Hong Kong Poison Information Centre on poisoning in 2019. Methods: This was a retrospective review of all poisoning cases recorded in the Poison Information and Clinical Management System of Hong Kong Poison Information Centre in 2019. Results: A total of 4016 poisoned cases were analysed, which involved 1698 men (42.3%), 2312 women (57.6%) and 6 sex-unspecified patients (0.1%). Majority of cases (77.3%) were between 13 and 69 years of age, and 10.5% were teenagers 13–19 years of age. Self-harm/suicidal attempt (42.1%), unintentional exposure (18.1%) and abusive substance use (11.1%) were common reasons of poisoning. Excluding ethanol, which was the common co-ingestant, the five most common types of poison were benzodiazepines, paracetamol, household products, zopiclone and Chinese herbal medicine. While most patients were managed with supportive treatment, 16.5% and 16.8% of the consultation cases were treated with decontamination and antidotes, respectively. Majority of cases recovered uneventfully, but 1.0% died and 4.7% had a major outcome. A total of six interesting cases and two outbreaks were discussed in this report. Conclusion: This 14th annual report provided updated epidemiological information on the pattern of poisoning in Hong Kong and highlighted a number of important changes compared with our previous reports.

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Section: Discussionsupporting

confidence: 84%

“…Concerning the method of decontamination, single-dose AC remained the most common, which is consistent with our local experience and overseas poison centre data. 1,2…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hong Kong Poison Information Centre: Annual report 2019

Chow

Chan

et al. 2022

Hong Kong j. emerg. med.

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“…12 All death or major effect cases were further reviewed by clinical toxicologist to ensure that the grading was appropriate. 13 There was no objective indicator to judge the degree of outcome severity in relation to lithium poisoning. Clinical outcomes of the patients can depend on individual susceptibility, co-morbidities, effects of acutely co-ingested drugs, or interactions with chronic medications.…”

Section: Study Limitationsmentioning

confidence: 99%

Evaluation of the utilization of extracorporeal toxin removal in lithium poisoning patients in Hong Kong

Chow

Chan

2023

Hong Kong j. emerg. med.

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Background: Extracorporeal toxin removal is used for enhanced elimination in severe lithium poisoning. The Extracorporeal TReatments In Poisoning workgroup provides recommendations on the use of extracorporeal toxin removal in poisoning. Objectives: Our aim was to identify the pattern for using extracorporeal toxin removal in managing lithium poisoning in Hong Kong and compare the outcomes in extracorporeal toxin removal-treated patients and non-extracorporeal toxin removal-treated patients if indicated for treatment as defined by The Extracorporeal TReatments In Poisoning criteria. Methods: Lithium poisoning presented between year 2009 and 2019 in Hong Kong Poison Information Centre (HKPIC) database was categorized into extracorporeal toxin removal-treated group and non-extracorporeal toxin removal-treated group. Comparative analyses were performed. Results: Among 112 lithium-poisoned patients, 21% were treated with extracorporeal toxin removal. Larger proportion of patients had fulfilled at least one Extracorporeal TReatments In Poisoning criteria for extracorporeal toxin removal in the extracorporeal toxin removal-treated group (87% vs 18%, p < 0.005). The extracorporeal toxin removal-treat group patients were more commonly presented with impaired consciousness, seizure and dysrhythmia ( p < 0.05). They also got higher admission (3.62 mmol/L vs 2.18 mmol/L, p < 0.05) and peak (4.15 mmol/L vs 2.28 mmol/L, p < 0.05) serum lithium concentrations, as well as a significantly higher serum creatinine concentration upon presentation (263.74 µmol/L vs 98.66 µmol/L, p < 0.05). Extracorporeal toxin removal-treat group patients more frequently had a severe poisoning outcome (91.3% vs 9%, p < 0.05) and developed complications (69.6% vs 13.5%, p < 0.05). Logistic regression identified seizure, peak serum lithium concentration, and serum creatinine concentration upon presentation as risk factors for severe poisoning outcome. In subgroup analysis on patients with at least one indication for extracorporeal toxin removal as defined by Extracorporeal TReatments In Poisoning criteria, the proportion of severe poisoning remained higher in the extracorporeal toxin removal-treated group (90% vs 43.7%, p < 0.05). Complication rate was not significantly different between the two groups. Conclusion: Clinically severe lithium poisoning patients were treated with extracorporeal toxin removal in Hong Kong. Extracorporeal TReatments In Poisoning criteria can serve as a reference in considering extracorporeal toxin removal treatment for lithium poisoning patients. Nevertheless, Extracorporeal TReatments In Poisoning criteria recommend more extracorporeal toxin removal treatment than it was actually done. Lithium poisoning patients with positive Extracorporeal TReatments In Poisoning criteria have been managed without extracorporeal toxin removal. No statistically significant adverse outcome was observed in these cases.

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“…Analgesic is one of the most commonly involved poisons in Hong Kong every year. [1][2][3][4][5][6][7][8][9][10][11][12] Since analgesics containing salicylates are readily available, salicylate poisoning may be encountered in the daily practice of the accident and emergency (A&E) department.…”

Section: Introductionmentioning

confidence: 99%

Prediction rule of supratherapeutic peak serum salicylate level in poisoning patients attending emergency departments

Wah

Keung

Tak

et al. 2022

Hong Kong Journal of Emergency Medicine

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Background: Analgesic poisoning is common in Hong Kong. Analgesics containing salicylate are easily available. Salicylate poisoning may be encountered in the daily practice of the accident and emergency department. The issue of routine salicylate screening was discussed in a number of articles, and the viewpoints of most authors were that routine salicylate screening was unnecessary. Objectives: The primary outcome is to explore the predictive factors of supratherapeutic peak serum salicylate level (>2.17 mmol/L) and delineate the role of routine screening serum salicylate level in poisoned patients attending the accident and emergency department. Methods: This is a retrospective cohort study. Poisoning cases presented to Hong Kong Poison Information Centre between 1 July 2008 and 31 October 2020 with serum salicylate level checked were included. The demographics, laboratory parameters and clinical outcomes were reviewed. Results: There were 8673 cases included with serum salicylate level checked, accounting for 17% of all poisoning cases. Sixty-six (0.76%) cases had supratherapeutic peak serum salicylate level and 11 (0.13%) of them were undeclared salicylate ingestion. Worse clinical outcomes were observed in cases with supratherapeutic peak serum salicylate level. Univariate analysis showed that tinnitus, hyperthermia, alkalaemia, metabolic acidosis, respiratory alkalosis and therapeutic use of aspirin were significantly associated with supratherapeutic peak serum salicylate level. Variables with p < 0.3 were entered into the backward stepwise logistic regression by likelihood ratio. A clinical prediction rule with three attributes (tinnitus, therapeutic use of aspirin and partial pressure of CO2 <5 kPa) was derived. It showed 100% sensitivity in internal validation. Conclusion: Serum salicylate level should be checked in poisoned patients with (1) tinnitus, (2) the therapeutic use of aspirin or (3) partial pressure of CO2 <5 kPa in arterial or venous blood gas. Routine salicylate screening remained a tool for clinicians not experienced in toxicology.

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Hong Kong Poison Information Centre: Annual report 2018

Cited by 4 publications

References 23 publications

Hong Kong Poison Information Centre: Annual report 2019

Hong Kong Poison Information Centre: Annual report 2019

Evaluation of the utilization of extracorporeal toxin removal in lithium poisoning patients in Hong Kong

Prediction rule of supratherapeutic peak serum salicylate level in poisoning patients attending emergency departments

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