Clinical and Epidemiological Study of Poisoning Cases Presenting to the Emergency Department of a Tertiary Care Center in Central India

Abstract

Objective To analyze the clinical and epidemiological characteristics of acute cases of poisoning and the pre-hospital measures that the patient receives before seeking care in an emergency department at a tertiary care center in Central India. Methods An observational prospective study was carried out over 18 months, and the relevant findings were documented using a predesigned data collection form. All patients who presented to the emergency department and were 18 years of age or older were recruited, and consent was sought. Data analysis was performed using the SPSS software. Results A total of 102 patients diagnosed with poisoning were taken for this study, and data were collected and analyzed. The mean age was 32.8 ± 13.75 years. Of the study population, 63 (61.8%) patients were males. In our study, the most common cause of poisoning was impulsive intake of poison (n = 22, 21.5%) and suicidal ingestion in patients with depression (n = 18, 17.6%). In the emergency department, 61 patients (59.8%) received gastric lavage, and 37 patients (36.3%) received an antidote. The most common agent of poisoning was pesticide ingestion, accounting for 45 (44%) of the total cases. Prescribed drugs were the second-largest group (n = 19, 18.6%). Other common poisoning agents were rodenticides (n = 12, 11.7%), corrosives (n = 8, 7.8%), and aluminum phosphide (n = 3, 2.9%). Out of 102 patients, 82 patients survived, 15 patients died, and five patients left against medical advice (LAMA). One patient had residual comorbidity and was discharged with jejunostomy. The maximum mortality (22.5%) was due to organophosphorus compounds. Conclusions While accidental encounters are also common, intentional self-harm accounts for the majority of poisonings; homicidal motives are less likely. Pesticides were the most often used poisoning agents, followed by prescribed and over-the-counter drugs, rodenticides, corrosive agents, and aluminum phosphide. Of the poisoned cases, 69.6% had a full recovery, 22.54% of them died, and eight (7.84%) among them left against medical advice (LAMA). Organophosphorus chemicals were the cause of the highest mortality (22.5%).

Keywords: emergency; epidemiology; organophosphorus; overdose; pesticide; poisoning; toxicology.

Figure 1. Frequency of the presenting complaints among the study population

The X-axis represents the common symptoms, and the Y-axis represents the frequency of particular symptoms (number).