Publication: A retrospective study on drug and chemical poisoning in Hospital Sultan Abdul Halim, Kedah
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Date
2022
Authors
Bakri, Muhamad Fakhurrazi Bin Mohamad
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Abstract
Introduction: Acute poisoning is a major public health concern, and cases continue to be seen in Malaysian hospitals. Complications of poisoning vary depending on the implicated agents and can range from mild gastrointestinal irritation to fatal multiorgan failure. Objectives: This study aims to determine the prevalence of poisoning presentations and the factors associated with severe outcome in acute drug and chemical poisoning. This study further looks into predictive risks of intentional poisoning. Methods: This was a retrospective cross-sectional study, case review study involving acute drug and chemical poisoning patients presented to the Emergency Department (ED), Hospital Sultan Abdul Halim (HSAH), Kedah, from 2016 until 2020. The cases were extracted from a computerised system, and the patient’s case records were retrieved from Medical Record Unit. Patients that fulfilled the study criteria were included. Their socio-demographic features and clinical presentation were collected. Logistic regression analysis was performed to determine the factors associated with severe outcome in acute drug and chemical poisoning. Logistic regression analysis was also performed to determine predictive risks of intentional poisoning. Results: A total of 147 cases were included with a mean age of 27.35 (SD ± 15.97) years old. Majority were males (51.0%), Indians (61.2%) and from the adult age group. Most of them were ‘non-professional’ (79.6%), without underlying illness (76.2%) and married (40.8%). The most common type of poison involved household products (25.2%), followed by drugs (24.5%), herbicides (24.5%), pesticides (19.0%) and miscellaneous agents (6.8%). Miscellaneous agents include petroleum/kerosene based, industrial acid and methanol. The majority of cases were intentional ingestion (74.8%). The prevalence of severe outcome was 33.3%. The mortality rate in our study was 2.7%. Patient with underlying medical illness (AOR=2.40, 95% CI=1.01, 5.70, p=0.046), presented with tachycardia (AOR=3.52, 95% CI=1.61, 7.73, p=0.002), presented with vomiting (AOR=4.88, 95% CI=1.40, 17.04, p=0.013) and presented with dyspnoea (AOR=3.75, 95% CI=1.16, 12.06, p=0.027) were found to have significant association with severe outcome. Indian (AOR=17.31, 95% CI=6.62, 45.25, p=<0.001) and Chinese (AOR=12.50, 95% CI=2.44, 63.96, p=0.002) had higher predictive risks for intentional poisoning. Conclusion: The prevalence of severe outcome was 33.3% in acute drug and chemical poisoning. Patients with comorbidities, who presented with tachycardia, vomiting and dyspnoea had a higher chance of severe outcome. The presence of these factors should alert clinicians on the need of rapid identification and early treatment in poisoning cases.
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Keywords
chemical poisoning , drug poisoning