A review of acute poisoning cases admitted in the MICU of a tertiary care hospital
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2017, Vol 24, Issue 2
Abstract
Aims: To study the age, sex, seasonal distribution and the clinical profile of different types of acute poisoning cases admitted to the ICU, and to determine outcome in the form of duration of stay and mortality and factors affecting it. Methods: This was a cross sectional observational study conducted in the MICU of a tertiary care hospital over a period of 12 months. Acute poisoning cases were studied. Outcome was measured in the form of duration of ICU stay and mortality. Results: There were a total of 714 admissions over 12 months, of which 149 were acute poisoning cases (20.8%). Among poisoning patients, males were 98/149 (65.7%). Age distribution: 12-19 yrs - 16.7%, 20-34 yrs - 44.9%, 35-49yrs - 26.1%, 50-69 yrs -10.7%, 70 yrs and above - 1.3%. Suicidal intent was the most common cause of poisoning (135/149, 90.6%). Pesticide is the most commonly used poison, majority being organophosphorus compounds OPC) (95/149 patients). Most common clinical features were vomiting, anxiety/ restlessness and cholinergic crisis. Most common ECG finding was bradycardia. Twenty two of 149 patients had a SOFA score of >11 (14.7%), 31 had score between 9 and 11 (20.8%) and 96 had score < 9 (64.4%). Most common complications seen were delirium due to atropinisation, electrolyte disturbance and intermediate syndrome. There were 22/ 149 deaths (Mortality of 14.7%), which was significantly less compared to mortality among non-poisoning group of patients (192/714,26.9%, p value < 0.01). Higher SOFA score significantly increased the risk of mortality among poisoning patients. (p- 0.01). Conclusion: Pesticides are the most common agents seen among the acute poisoning admissions in the MICU and young adult male population constitute majority. Mortality among the poisoning patients was significantly lower compared to the non-poisoning patients, and was mainly due to OPC. Higher SOFA score was associated with adverse outcome among the poisoning patients.
Authors and Affiliations
Kanchana S Pillai, Trupti H Trivedi, Nivedita D Moulick
Keywords
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