Retrospective examination of drug poisonings admitted to adult emergency service between the years 2013 and 2016 and comparison of the efficiency of treatment protocols

Objective: The objective of our study was to examine the demographic and etiological features of the acute poisoning cases admitted to the Emergency Service, to examine the active substances taken and their properties, laboratory findings and clinical features retrospectively and to introduce which measures can be taken. Material and methods: In our 3-year-long retrospective study, age, gender, date of coming to hospital, period of hospitalization in the emergency service and the intensive care and clinical outcome of the patients; active ingredients and amount of the drugs taken; antidote and extracorporeal treatment given and the laboratory findings of the cases were examined. SPSS 18.0 (SPSS Inc, Chicago, IL, USA) program was used for the statistical analysis of the data. Results: Within 3 years, 535 cases were admitted with drug intake, 483 patients were included in the study since it was not possible to reach the ingredients of the drugs used by 52 of the patients. 310 (64,2%) of the patients were female, while 173 (35,8%) were male. Average age of the patients was 33,40±12,48 (37,58±14,66 for men, 31,35±10,56 for women). The difference between the average age of men and women was found to be statistically significant (p<0.001). While 179 (37,1%) of the patients were followed for an average of 3,21±4,5 days in the intensive care, 304 (62,9%) were followed for an average of 2,1±2 days in the emergency service. A statistically significant difference was found between total period of hospitalization and the lactate level at the moment of admission (r=422, p=0,06). When the correlation between the glucose level and the total period of hospitalization and lactate and period of hospitalization in the intensive care was examined among 29 cases poisoned with pesticides, statistically significant correlation was found. The most common reason for poisoning was antidepressants seen in 87 (18%) of the patients, paracetamol in 70 (14,5%) of the patients, NSAII in 59 (12,2%) and antipsychotic drugs in 53 (11%) of the patients. The most frequently taken antidepressant was SSRI 52 (58,4%). When it was examined whether the drugs taken were lipophilic or not, it was found that 191 cases (39,5%) were hospitalized for 3,2±4,9 days with only lipophilic drugs, 100 cases (20,7%) were hospitalized for 3,0±3,6 days with lipophilic drugs and an additional active substance, 83 cases (17,2%) were hospitalized for 2,6±2,4 days with only hydrophilic drugs and 109 (22,6%) cases were hospitalized for 2,4±1,8 days with hydrophilic drugs and an additional active substance. 14 patients received extracorporeal treatment. Our mortality was found to be 0,62% and exitus cases consisted of one patient poisoned with methyl alcohol, one patient poisoned with carbamate and one patient poisoned with organophosphate active ingredient. Conclusion: Most of the poisonings were observed to occur with suicidal purposes, among young people and among women. Problems of young women should be defined and solved in our country. In cases of poisoning, early intervention is life-saving. Mortality can be decreased with supportive treatment, antidotes and extracorporeal techniques; however, toxicological guides (IV lipid, extracorporeal techniques, etc.) should be formed with more extensive studies to guide clinicians. Key words: emergency, poisoning, lipophilicity, lactate, intoxication, extracorporeal treatment, mortality, period of hospitalization, lipid