Acute poisoning in children admitted to pediatric emergency department: a five-years retrospective analysis

Main Article Content

Paolo Maurizio Soave
Antonietta Curatola https://orcid.org/0000-0002-2430-9876
Serena Ferretti
Vincenzo Raitano
Giorgio Conti
Antonio Gatto
Antonio Chiaretti

Keywords

children, pediatric, poisoning, toxicology, personalized medicine

Abstract

Background and aim: to identify most frequent risk factors and to propose prevention strategies for the children admitted to Pediatric Emergency Department (PED) with acute poisoning.


Methods: We performed a retrospective study in a tertiary care hospital, describing the frequency and nature of pediatric poisoning, clinical management and outcome.


Results: We collected data of 436 children admitted for acute poisoning. The mean age was 30 months and 51.1% were male. Most poisoning incidents (90.1%) were unintentional and drug ingestion (39.4%) was the leading cause of poisoning. Acute poisoning happened at home in 83,7% of cases and the mother was the most frequent caregiver during the event in 61.5%. No died were reported.


Conclusion: Our study showed that the two categories of patients at greatest risk for acute poisoning are children under 3 years and adolescents over 12 years. Adequate information campaigns about toxic substances are essential for children, adolescents and their parents.

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References

1. Kalseen CD, Andur MO, Doull J. Casarett and Doull’s Toxicology. Newyork: Macmillan, 1986
2. Bacha T, Tilahun B. A cross-sectional study of children with acute poisoning: a three-year retrospective analysis. World J Emerg Med. 2015;6:265e9.
3. Woo JH, Ryoo E. Poisoning in Korean children and adolescents. Pediatr Gastroenterol Hepatol Nutr. 2013;16:233e9.
4. Bond GR, Woodward RW, Ho M. The growing impact of pediatric pharmaceutical poisoning. J Pediatr. 2012;160:265e70.
5. Gummin D, Mowry JB, Spyker DA, et al. 2018 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 36th Annual Report. Clinical Toxicology 2019; 57: 1220-1413.
6. Hyder AA, Wali S, Fishman S, Schenk E. The burden of unintentional injuries among the under-fi ve population in South Asia. Acta Paediatrica. 2008; 97: 267–275.
7. Peden MK, Sharma G. The Injury Chart Book: A graphical overview of the global burden of injuries. Geneva: World Health Organization, 2002.
8. Rakovcová H. Drug poisoning in children (in Czech). Pediatr praxis. 2013; 14: 126-129
9. Von Mühlendahl Ke, Oberdisse U, Bunjes R, et al. 4 Auflage. Thieme Verlag, Stuttgart, German, 2003, pp 10-75.
10. Bentur Y, Obchinikov Nd, Cahana A, et al. Pediatric poisonings in Israel: National Poison Center data. Isr Med Assoc J. 2010; 12: 554-559
11. Lin YR, Wu TK, Liu TA, et al. Poison exposure and outcome of children admitted to a pediatric emergency department. World J Pediatr. 2011;7:143e9.
12. Mintegi S, Azkunaga B, Prego J, et al. International epidemiological differences in acute poisonings in pediatric emergency departments. Pediatr Emerg Care. 2019; 35:50–57.
13. Mintegi S, Fernández A, Alustiza J, et al. Emergency visits for childhood poisoning: a 2-year prospective multicenter survey in Spain. Pediatr Emerg Care. 2006; 22:334–338.
14. Akin Y, Ağzikuru T, Cömert S, et al. Hospitalizations for pediatric intoxication: a study from Istanbul. Turk J Pediatr. 2011; 53: 369-374
15. Andiran N, Sarikayalar F. Pattern of acute poisonings in childhood in Ankara: what has changed in twenty years? Turk J Pediatr. 2004; 46: 147-152
16. Ouédraogo M, Ouédraogo M, Yéré S, et al. Acute intoxications in two university hospitals in Burkina Faso. Afr Health Sci. 2012; 12: 483-486
17. Zhang Y, Yu B, Wang N, et al. Acute poisoning in Shenyang, China: a retrospective and descriptive study from 2012 to 2016. BMJ Open. 2018;8(8):e021881.
18. Dayasiri MBKC, Jayamanne SF, Jayasinghe CY. Patterns and outcome of acute poisoning among children in rural Sri Lanka. BMC Pediatr. 2018;18(1):274.
19. Manzar N, Saad SM, Manzar B, et al. The study of etiological and demographic characteristics of acute household accidental poisoning in children - a consecutive case series study from Pakistan. BMC Pediatr. 2010; 10, 28
20. Dinis-Oliveira RJ, Magalhães T. Children intoxications: what is abuse and what is not abuse. Trauma Violence Abuse. 2013;14(2):113-132
21. Ramos CL, Barros HM, Stein AT, et al. Risk factors contributing to childhood poisoning. J Pediatr (Rio J). 2010;86(5):435-440
22. Gaw CE, Spiller HA, Casavant MJ, et al. Safety Interventions and Liquid Laundry Detergent Packet Exposures. Pediatrics. 2019;144(1):e20183117.
23. Rodgers GB, Franklin RL, Midgett JD. Unintentional paediatric ingestion poisonings and the role of imitative behaviour. Inj Prev. 2012;18(2):103-108.
24. Agarwal G, Bithu KS, Agarwal R. An epidemiological study of acute poisoning in children in a tertiary care hospital of western Rajasthan, India. Int J Contemp Pediatr. 2016;3:1249e51.
25. Ravindras H, Lavlesh K, Kumar SA, et al. A study of pediatric poisoning cases at district hospital, Belgaum, Karnataka. Medico Legal Update Int J. 2010;10:17e50.
26. Yang CC, Wu JF, Ong HC, et al. Children poisoning in Taiwan. Indian J Pediatr. 1997;64:469e83.
27. Gielen AC, Wilson ME, Faden RR, et al. In-home injury prevention practices for infants and toddlers: the role of parental beliefs, barriers, and housing quality. Health Educ Q. 1995;22:85–95.
28. Mintegi S, Azkunaga B, Prego J, et al. International Epidemiological Differences in Acute Poisonings in Pediatric Emergency Departments. Pediatr Emerg Care. 2019;35(1):50‐57.
29. Burghardt LC, Ayers JW, Brownstein JS, et al. Adult prescription drug use and pediatric medication exposures and poisonings. Pediatrics. 2013; 132: 18-27.