A nationwide study of patients hospitalised for poisoning in Korea based on Korea National Hospital Discharge In-Depth Injury Survey data from 2005 to 2009

Factors affecting treatment outcomes of hospital injury patients in Korea

Objectives

To analyze the characteristics of hospital injured patients and the factors that affect treatment results.

Methods

We used the data from the Korea National Hospital Discharge In-depth Injury Survey from 2019 to 2021 of the Korea Disease Control and Prevention Agency (KDCA), 18,037 people who experienced hospital injury accidents were analyzed. In a retrospective cross-sectional study, general characteristics and injury-related characteristics of patients with hospital-acquired injuries were collected. The data were analyzed using chi-square test and logistic regression analysis of complex sampling design. The significance of all statistical analyses was verified at the p-value (<0.05) level.

Results

Variables that significantly affected the death of patients with hospital injuries were gender, age, route of admission, type of hospital injury, principal diagnosis, and length of stay (p < 0.05). The risk of death was 3.174 times (95% confidence interval: 2.376-4.238) higher when neoplasm was the principal diagnosis compared to cases with principal diagnosis of other systems.

Conclusions

It is necessary to do patient safety education to help medical personnel be more aware of groups of patients who had a high risk of death from hospital damage, such as male and elderly patients, patients who admitted through the emergency room, and patients whose principal diagnosis was neoplasm, circulatory system, or respiratory system disease.

Trends of acute drug and chemical toxicities in adults and adolescents in Tehran, Iran between 2012 and 2018: a retrospective chart review

Poisoning is among the top three common causes of suicidal deaths in Iran. We aimed to evaluate the epidemiologic trend of poisoning and its mortality rate in the largest tertiary toxicology referral center in Iran between 2012 and 2018. A total of 84,242 patients were hospitalized or died due to poisoning in this center during the study period, of whom 2114 (2.5%) died. The most frequent poisonings were those with antiepileptics, sedativehypnotics, and antiparkinson medications (T42) followed by narcotics and psychodysleptics (T40). Psychodysleptics had the highest mortality rate (684; 32.4% of the deaths). Among drugs of abuse, methadone was the most common cause of admission reported in 10,398 cases (12.3%). In conclusion, suicidal or recreational methadone poisoning is becoming the most common cause of admission to poisoning referral wards in Iran. Rigorous supervision of daily dosing at opioid maintenance clinics as well as efforts to control the black-market offering methadone are needed to prevent further methadone-related acute poisonings and deaths.

Epidemiologic characteristics of hospitalised patients after suicidal acts from 2005 to 2016 in Korea: Analysis of the Korean National Hospital Discharge Survey

BACKGROUND

Suicide is a major cause of death in many countries, and previous suicidal attempt is known to be the predictor of future suicide. Korea is considered one of the countries with the highest suicide rate among the Organisation for Economic Co-operation and Development (OECD) members for over a decade. We aimed to investigate the epidemiologic characteristics of hospitalised patients after suicidal acts in Korea.

METHODS

Data from the Korean National Hospital Discharge In-depth Injury Survey were analysed, and patients older than 9 years admitted to nationwide hospitals after suicidal acts from 2005 to 2016 were included. Their epidemiologic characteristics were explored, and we divided them into groups according to suicidal means (injury vs. poisoning) and treatment outcome (good vs. poor). The association of each characteristic with injury as suicidal means and with poor treatment outcome were explored.

RESULTS

The sample included 7609 patients (corresponding to 227,571 in national population). More patients were female than male, and most were in their 40s in both sexes. Hospitalisation rate peaked in patients older than 80 years for both sexes. Male and young patients aged 10-19 years and capital residents showed relatively higher odds of choosing injury as suicidal means. Males and patients aged 40-64 and ≥65 years showed relatively higher odds of poor treatment outcome.

LIMITATIONS

Some suicide attempters were excluded from the survey such as those who did not visit a hospital after the suicide attempt.

CONCLUSIONS

This epidemiologic feature of suicide attempters might serve as baseline data for preventive policies regarding suicide.

Epidemiology and regional differences of acute poisonings of eight cities in Gyeonggi-do province in Korea using data from the National Emergency Department Information System of Korea

OBJECTIVE

We aimed to analyze the differences in epidemiological aspects and clinical courses of acute poisonings in each region of the Gyeonggi-do province in Korea.

METHODS

This retrospective study analyzed data from the National Emergency Department Information System of Korea. We retrospectively reviewed cases of acute poisonings between April 2006 and March 2015 recorded at 13 emergency departments in eight different cities of Gyeonggi-do province in Korea. The differences in the incidence, age distribution, causative agent, and clinical course of poisonings among regions were the main outcomes measured.

RESULTS

The proportion of poisonings in the ≤9 age group was high in Yongin (17.44%) and that in ≥65 age group was high in Gwangmyeong (21.76%). The proportion of cases involving carbon monoxide was high in Ansan (8.82%) in patients hospitalized and the proportion of cases involving pesticides was high in Pyeongtaek (52.78%) in patients admitted to the intensive care unit. The admission rate of poisoned patients was high in Osan (36.02%).

CONCLUSION

In this study, differences in the characteristics of poisoned patients between 8 cities were noted. Therefore, hospitals need to arrange treatment resources for poisoned patients according to the characteristics of the specific region. The.

RESULTS

of this study may serve as evidence for new strategies to prepare for the acute poisonings in hospitals.

Toxicological exposures reported to a telephonic consultation service at a tertiary care hospital in Lebanon

Introduction: This study aims to describe the epidemiology of toxicological exposures reported to a telephonic medical toxicology service at a tertiary care center in Lebanon during a 46-months period.Methods: This study is a secondary analysis of a database for a telephonic medical toxicology service at a tertiary care center in Lebanon. Clinical information from all pediatric and adult patients, presenting with intentional or unintentional toxicological exposure, was entered into the database by the medical toxicology team.Results: Four hundred and seventy-seven exposures were recorded from 1 March 2015 to 31 December 2018. Female patients were involved in 60.2% of cases. Children less than 5 years old constituted 23.5% of cases and adults aged 20-49 constituted 48.6%. Up to 51.6% of cases were intentional, with 37.7% resulting from suicidal attempts. The majority of patients displayed no effects (33.1%) or minor effects (39.2%). Almost half of patients were treated and discharged from the Emergency Department (ED) without further hospitalization, and another 18.9% of patients left the ED against medical advice. The most common pharmaceutical agents involved were sedative/hypnotics/antipsychotics (14.7%), analgesics (12.6%) and antidepressants (11.3%). The most common non-pharmaceutical agents involved were household cleaning substances (8.0%), pesticides (5.2%) and bites and envenomations (3.8%).Conclusions: The results of this study suggest that sedative/hypnotics/antipsychotics, analgesics, antidepressants and household cleaning substances are the most common agents involved. Adult women and children ≤5 years old constitute a large portion of patients with toxicological exposures. Prevention strategies and policies should be implemented to mitigate these hazards.

Subjective Symptoms of Male Workers Linked to Occupational Pesticide Exposure on Coffee Plantations in the Jarabacoa Region, Dominican Republic

Acute and sub-acute effects of pesticide use in coffee farmers have rarely been investigated. In the present field study, self-reported health symptoms from 38 male pesticide users were compared to those of 33 organic farmers. Results of cytological findings have been reported in an accompanying paper in this issue. The present second part of the study comprises a questionnaire based survey for various, potentially pesticide related symptoms among the coffee farmers. Symptom rates were generally higher in exposed workers, reaching significance in nine out of 19 assessed symptoms. Significantly increased symptom frequencies were related to neurotoxicity, parasympathic effects and acetylcholine esterase inhibition, with the highest differences found for excessive salivation, dizziness and stomach ache. We revealed a lack of precautionary measures in the majority of farmers. Better education, regulations, and safety equipment are urgently needed.

Acute Pesticide Poisoning in Children: Hospital Review in Selected Hospitals of Tanzania

BACKGROUND

Acute pesticide poisoning (APP) is a serious problem worldwide. Because the burden of childhood APP is unknown in Tanzania, this study describes the distribution, circumstances, and patterns of APP involving children under 18 years in Tanzania.

METHODOLOGY

A 12-month prospective study was conducted in 10 Tanzanian healthcare facilities in 2006 using a data collection tool for surveillance.

RESULTS

Of 53 childhood poisoning cases identified, 56.6% were female. The most common poisoning circumstances were accidents (49.1%) and suicide (30.2%). The most vulnerable children were 16-17 years old (30.2%). Suicide was significantly more common in females (PRR females/males = 1.66; 95% CI = 1.03-2.68) and accidental cases were more common in children aged 10 years or younger. Suicide was concentrated in children over 10 years, comprising 53% of cases in this age group. Organophosphates (OPs), zinc phosphide, and endosulfan were common amongst reported poisoning agents. The annual APP incidence rate was 1.61/100,000.

CONCLUSION

APP is common among children in this region of Tanzania. Prevention of suicide in older children should address mental health issues and control access to toxic pesticides. Prevention of accidents in younger children requires safer storage and hygiene measures. Diverse interventions are needed to reduce pesticide poisoning among children in Tanzania.

Childhood pesticide poisoning in Zhejiang, China: a retrospective analysis from 2006 to 2015

Background

Pesticide poisoning in children has been a serious public health issue around the world, especially in the developing countries where agriculture is still one of the largest economic sectors. The purpose of this study was to analyze epidemiological characteristics of acute pesticide poisoning in children from Zhejiang province, China.

Methods

The pesticide poisoning cases for children were retrieved from Occupational Disease Surveillance and Reporting System, Zhejiang Provincial Center for Disease Control and Prevention, China. The incident cases, deaths, and fatality rate of child pesticide poisoning from 2006 through 2015 were calculated.

Results

During the study period, totally 2952 children were poisoned by pesticides, with 66 deaths, resulting in a fatality rate of 2.24%. Among them, there were 1607 male cases with 28 deaths, and 1345 female cases with 38 deaths. Most of the cases occurred in preschool children (1349) and adolescent age group (1269). Organophosphate and carbamate insecticides were the cause of most poisonings (1130), leading to 34 deaths. The highest fatality rate (3.13%) was due to poisoning by herbicides and fungicides, causing 14 deaths out of 448 cases. Poisoning occurred mostly in rural areas (78%). And most pesticide poisoning occurred in the summer (896) and fall (811), while fewest poisoning cases in the winter (483) but with the highest fatality rate (3.52%).

Conclusions

This study shows that pesticide poisoning of children is a major health problem in Zhejiang, suggesting preventive strategies should be conducted to control childhood pesticide poisoning.

Epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge in Japan: An exploratory descriptive study using a nationwide claims database

Background

Little is known about the nationwide epidemiology of the annual rate, causative substance, and clinical course of overdose-related admission. We aimed to describe the epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge to home.

Methods

We assessed all cases of admission due to overdose (21,663 episodes) in Japan from October 2012 through September 2013 using the National Database of Health Insurance Claims and Specific Health Checkups of Japan.

Results

The annual rate of overdose admission was 17.0 per 100,000 population. Women exhibited two peaks in admission rates at 19–34 years (40.9 per 100,000) and ≥75 years (27.8 per 100,000). Men exhibited one peak in the admission rate at ≥75 years (23.7 per 100,000). Within 90 days prior to overdose, ≥60% and ≥9% of patients aged 19–49 years received a prescription for benzodiazepines and barbiturates, respectively. In addition, 59% of patients aged ≥75 years received a prescription for benzodiazepines prior to overdose, 47% had a history of congestive heart failure, and 24% had a diagnosis of poisoning by cardiovascular drugs. The proportion of patients with recent psychiatric treatments decreased with age (65.1% in those aged 35–49 years and 13.9% in those aged ≥75 years).

Conclusions

The findings emphasize the need for overdose prevention programs that focus on psychiatric patients aged 19–49 years who are prescribed benzodiazepines or barbiturates and on non-psychiatric patients aged ≥75 years who are prescribed benzodiazepines or digitalis.

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Benzodiazepines were prescribed to ≥59% of overdose patients aged ≥19 years.

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Cardiovascular drugs were frequently ingested among overdose patients aged ≥75 years.

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The proportions of patients with recent psychiatric treatments decreased with age.

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Overdose prevention should be optimized according to the age-related differences.