Poisonings in childhood: A 5-year experience of a tertiary city hospital in İstanbul

Abstract

Objective: Poisoning is a substantial public health problem preventable with basic precautions. This study aims to contribute to the literature by analyzing the demographic variables, epidemiological characteristics, and prognosis of children brought to the pediatric emergency department of our center due to poisoning in the last five years. Methods:We retrospectively evaluated the medical records of 1928 patients who were under-18 years old and admitted with acute intoxication diagnosis to our tertiary hospital's pediatric emergency department in Istanbul between 2016 and 2021. Patients were divided into two groups by poisoning factors: drug and non-drug substances. Results:We included all 1928 patients (55.1% male, 44.9% female). The median age was 30 (20-49) months, and 85.5% (n=1650) of patients were under 72 months old. There was a male gender dominance (62.4%) among patients aged 3-6, all of whom had accidental poisoning (100%). Poisonings among patients older than 12years of age were more common in girls (59.8%) and were mainly suicidal attempts (65.2%). We detected drug exposure in 58.9% (n=1047) of patients; the most common drugs were analgesics (13.5%, n=269), psychotropics (6.2%, n=102), and hormone preparations (4.5%, n=86). We also detected non-drug exposure in 41.1% (n=792) of patients; the most common non-drug substances were corrosive-caustic substances (14.6%, n=284), and detergent poisonings (5.5%, n=106). None of the patients died. Conclusion:Patients in the under 6 years old group admitted due to poisoning were predominantly male, and all cases were accidental. Whereas poisonings above the age of 12 were more common in girls and were usually due to suicide. Our study also showed that poisonings in children passed with milder symptoms, and we discharged most of the children after a short observation without the need for hospitalization. Well-balanced clinical management may prevent unnecessary hospitalization and unnecessary medical interventions.

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 ].…”

“…Gastric lavage was applied to 157 patients (66.5%). In the pediatric age group, activated charcoal and gastric lavage remain the most frequently used treatments [ 25 , 30 ]. The use of activated carbon and gastric lavage in children depends on the poisoning agent and the time elapsed between poisoning and the patient’s admission to the emergency department [ 25 ].…”

“…The higher prevalence in boys seems to be due to the nature of boys who are more active and adventurous than girls, however, the exact reason is unknown [ 4 , 17 ]. In some studies, the highest frequency of unintentional poisoning has been reported in the age group under 5 years [ 4 , 6 , 16 , 25 ] or 1–3 years [ 19 , 23 , 24 , 31 – 33 ]. And in most studies unintentional poisoning was higher in boys than in girls [ 4 , 22 , 34 , 35 ], yet in some studies was higher in girls [ 31 , 36 ].…”