Mushroom Intoxication in Türkiye: A Nationwide Cohort Study Based on Demographic Trends, Seasonal Variations, and the Impact of Climate Change on Incidence

Abstract

Background/aims: Mushroom intoxication poses a considerable public health risk due to its potential for severe toxicity and fatality. This study aims to investigate demographic trends, diagnostic locations, and mortality rates of patients with mushroom intoxication.

Materials and methods: This retrospective cohort study utilized data from the National Electronic Database of the Turkish Ministry of Health. The study focused on patients without chronic liver disease or prior liver transplantation presenting with mushroom intoxication between 2018 and 2023. Demographic information, diagnostic locations, and mortality rates were analyzed, considering a six-year period to ensure even seasonal distribution.

Results: Among 30459 individuals admitted with mushroom intoxication, 44.75% were male, with a mean age of 45.84 years. The Black Sea, Marmara, and Central Anatolia regions had the highest number of cases, with specific cities like Tokat, Bolu, Yozgat, and Kastamonu having the highest rates per 100,000 population in 2022. Mushroom intoxication predominantly occurred in May, June, October, and November. Hospitalization occurred in 8.9% of cases, with a 6.6% mortality rate within 90 days and 1.3% progressing to liver transplantation. Notably, mushroom intoxication cases increased by 130% in the first half of 2023, particularly in May and June, correlating with increased rainfall.

Conclusion: Mushroom intoxication is a serious public health issue, with morbidity and mortality influenced by climate factors. The study highlights a significant increase in cases in the first half of 2023, potentially linked to heightened rainfall and climate change.

Keywords: Climate change; mushroom intoxication; morbidity; mortality.

Figure 1.

Flow chart: The clinical course of patients who were admitted to the hospital with mushroom intoxication.

Figure 2.

Number of cases by year.

Figure 3.

Percentage distribution of mushroom intoxication cases by region.

Figure 4.

Distribution of cases in 2022, calculated per 100 000 people for each city.

Figure 5.

Monthly distribution of mushroom intoxication in Türkiye. The bar represents the sum of patients diagnosed during the same year throughout the study period (2018-2023).

Supplementary Figure 1

90-day Mortality and Liver Transplants (All Years) 90-day Mortality: The number of patients who died within 90 days after hospitalization each month across all years. Liver Transplants: The number of patients who underwent liver transplantation each month across all years.