Pharmaceutical toxicity is a common pattern of inpatient acute poisonings in Birjand City, East of Iran

Abstract

Information on the pattern of acute poisonings in hospitals of Birjand city, Iran, is limited. This study aimed to address this knowledge gap by examining the admissions in a major poisoning center in eastern Iran. This cross-sectional study included patients admitted to the Imam Reza Hospital in Birjand over 12 months. Medical records of the poisoned patients were reviewed, and the study variables were used for data analysis. During the study period, 534 cases of acute poisonings were evaluated. The patient's ages ranged from 12 to 84 years, with a high rate of poisonings between 15 and 35 years. The female predominance in poisoning cases was 52.1%. Most cases of poisonings occurred in spring, and the common route of exposure was oral (93.1%). The incidence of poisoning in married couples, uneducated patients, and residents of urban areas was 56.5%, 90.1%, and 74.6%, respectively. Patients with a previous medical history experienced addiction and psychiatric disorders. Intentional poisoning accounted for 23.4% of acute poisoning cases referred to the hospital in the current study. The main groups of toxicants were pharmaceutical products (48.1%), narcotics (25.8%), chemical products (10.1%), envenomation (7.1%), and alcohol (1.7%). The mean hospital stay was 2.5 ± 3.0 days, and the final treatment outcome was complete recovery, except for one patient intoxicated by warfarin and alprazolam. Our results indicate that the high toxicity cases were related to pharmaceutical product and opioids abuse, especially methadone (8.4%), alprazolam (7.9%), clonazepam (7.5%), and acetaminophen (9.9%) taken orally and more commonly happened at home. Due to the high rate of deliberate poisonings, especially among young adults and students, monitoring drug distribution and exceptional attention to mental health should be seriously considered by national health authorities to prevent suicide attempts.

Clinico-epidemiological evaluation of pharmaceutical/non-pharmaceutical poisoning in a referral poisoning emergency in the Central part of Iran

“…Our results showed that pharmaceutical poisoning was more common in females which is similar to other studies in Iran 20 . However, non-pharmaceutical poisoning was observed more in men.…”

“…Similar to other studies 20 , 26 , 27 , the highest rate of poisoning was observed among individuals aged 20–40 years. In light of the wide range of risk factors associated with poisoning, it is likely that multiple psychosocial, drug availability and economic factors played a role.…”

“…The history of addiction was higher in non-pharmaceutical poisoning compared to pharmaceutical poisoning. In another study, the frequency of addiction differed between the two groups, with patients who had a history of addiction and psychiatric disorders being more likely to experience non-pharmaceutical poisoning 20 . Dragisic et al reported that psychiatric history and addiction were common among patients who committed suicide 41 .…”

Poisoning in children and adolescents in Kermanshah city, Iran

“…Poisoning is a significant public health problem and it is one of the common reasons for referral to the emergency department of the hospitals [ 23 , 24 ]. Most poisonings are seen in children and adolescents and approximately 0.5-2% of the reasons for applying to emergency outpatient clinics are in childhood [ 25 , 26 ], on the other hand at least 500,000 people die annually from poisoning worldwide [ 27 , 28 ]. Non-fatal poisoning is 20–30 times more prevalent and often causes long-term morbidities that severely reduce patients’ quality of life and put a strain on healthcare services and society worldwide [ 29 ].…”

“…In some studies, the prevalence of unintentional poisoning, like our study, was higher in autumn [ 19 ], and in others, it was in spring [ 44 , 49 ]and summer [ 22 , 39 ]. This discrepancy might be due to the geographical diversity and the incidence of envenomation [ 27 ]. and previous studies report that intentional poisonings occurred in spring [ 42 ], fall and, winter and, the least in the summer [ 47 , 50 ].…”