Parasuicidal poisoning treated in a Greek medical ward: epidemiology and clinical experience

Abstract

<jats:p> Objective: To study the epidemiology of acute poisoning patients presenting to an acute medical service ward in a Greek hospital between January 1998 and December 2000. Design: Prospective case series. Results: A total of 273 patients with self-poisoning were included in the study. This represented 3.8% of the overall admissions to the unit. The mean age of patients was 33, the most frequent age group being that aged 20–30 years (36.2% of total) with a male-to-female ratio of 1:1.97. Sixty per cent of patients was admitted within 4 h. Those from urban areas comprised 76.2% and 23.8% from rural areas. The most frequently ingested agents were psychopharmaceuticals (37.4%) and analgesics/anti-rheumatics (32.6%). Pesticides (7.7% of total) were most frequently used by patients coming from rural areas (32.3% of patients from rural areas). Alcohol was included in the overdose in 8.4%. Of the patients, 16.2% had a previous history of overdose. In this case series, psychiatric assessment suggested that 52% of the patients had a formal psychotic diagnosis, 21% had personality disorder and 27% had taken an overdose in response to stress. The most frequently documented precipitating factors were family problems and disputes (37%). Unusually, the seasonal distribution in these patients suggested a peak in summer (37.5% of presentations) with lower numbers in spring (30.2%), autumn (17.7%) and winter (14.6%). Of the patients, 23.7% presented in July. A total of 73.5% of patients was conscious, 16.4% was somnolent, 4.5% was in precoma and 5.6% was in coma (GCS &lt;8). Patients who received antidotal therapy comprised 17.9%. Evidence of hepatic dysfunction was observed in 8.9% of patients and renal dysfunction in 3.6%. Extracorporeal techniques for drug removal (hemodialysis and hemoperfusion) were used in 2.2% of patients. Intensive care therapy was required in 11.4% of patients. The mean overall hospitalization time was 3.3 days. The mortality rate was 2.9%. Conclusions: This study shows that the epidemiology of self-harm by overdose in Greece is significantly different in terms of the seasonal presentation from other parts of Europe. The agents ingested and other features are similar to northern Europe. Psychiatric diagnoses are more common in our group than in those reported from northern Europe. </jats:p>

Acute intoxications in two university hospitals in Burkina Faso

“…12 We found that females were predominant among poisoned-patients. This female predominance among acute poisoned-patients was reported in Zimbabwean 6 , Greek 13 , Turkish 14 , and Iranian studies 15 . Most admissions in the emergency services of the two University Hospitals due to acute intoxications resulted from accidental poisoning.…”

Suicidal Cardiovascular Drug Intoxication in Emergency Department

“…[2,15] No age difference was found between cardiovascular drug intoxication and other types of drug intoxication in our study. [16,17] In this study, cardiovascular drug intoxication was found to be more common in 10 to 30 years old patients. Cardiovascular drug intoxications are more common between 18:00 and 02:00.…”

Fatal Poisonings in the South Marmara Region of Turkey

“…This situation is in consistent with the other studies in our country (2,15,16). However, many hospital-based studies from our country and from those conducted in the other countries have reported that majority of patients exposed to poisoning was female (3)(4)(5)(6)(7)(8)(17)(18)(19)(20) When the deaths due to poisonings are analysed, carbon monoxide is found to be the most common type of poisoning in south Marmara region, while the insecticides are the most common poison in İzmir, the Aegean region, and in Adana, the Mediterranean region of Turkey (2,15,16). The relatively higher incidence of carbon monoxide intoxication in this study was resulted from the cases that are found to be exposed to carbon monoxide originating from stove smoke driven back from chimneys by strong southwest wind, which is a common experience in our region.…”

“…Death due to poisoning has been known since time immemorial. Poisoning is a major problem all over the world although its type and the associated morbidity and mortality vary from country to country (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). According to the legal system of our country, all poisoning death cases are recorded as unnatural death and in addition, in Turkey, according to the article 89 of the Penal Code Law Judicial Procedure (12); any case of death due to suspected or obvious poisoning must undergo the medico-legal autopsy.…”