Ten-year analysis of poisoning cases admitted to the emergency department

ABSTRACT Ten-Year Analysis of Poisoning Cases Admitted to the Emergency Department Aim: Poisoning is a significant reason for visits to the emergency department. This study aims to map the poisoning profile of the region by conducting a retrospective 10-year analysis of poisoning cases presented to the Department of Emergency Medicine at Çukurova University. Methods: From November 2012 to December 2022, 5513 poisoning cases were included in the study out of 689.377 patients aged 18 and over who presented to the emergency department. The patients were evaluated retrospectively by reviewing the hospital automation system, emergency department patient cards, and files. The demographic data of the patients, time of admission, cause of poisoning, and treatment processes were analyzed. Results: Of the patients, 58.6% were women, with the most common age of admission being between 21 and 34 years. 78.1% of the poisoning cases were due to suicide attempts. 71.5% of the poisoning cases were caused by drugs (most frequently NSAIDs - 14.2%), with the most lethal being antiarrhythmics. Toxic alcohol and pesticide poisonings were other lethal causes. The mortality rate was 1.3%. In the age-standardized regression model, female gender increased the risk of poor clinical course by 1.7 times (95% CI: 1.3-2.2, p=0.0001), and arriving at the hospital 7 hours or more after the incident increased the risk by 1.4 times (95% CI: 1.1-2.0, p=0.041). The presence of chronic systemic disease (OR: 1.4, 95% CI: 1.0-2.0, p=0.028) and psychiatric disease (OR: 2.0, 95% CI: 1.5-2.6, p=0.0001) were significant risk factors. When "poisoning with recreational substances," which had the lowest poor clinical course, was taken as the reference, accidental poisoning was found to be the factor that increased the risk of poor clinical course the most (OR: 7.0, 95% CI: 3.5-14.1, p=0.0001). Diagnosis, treatment, follow-up, and discharge of 95.5% (n=5266) of all cases were performed in the Department of Emergency Medicine. Conclusion: In our region, the most common poisonings were caused by NSAIDs, while among drugs, antiarrhythmics were the most lethal. Agricultural pesticides and toxic alcohols were other causes of lethal poisonings. It is important to identify individuals at risk of suicide early, increase supervision, and organize awareness-raising education in rural areas. Early intervention and effective treatment in the presence of conditions that worsen the clinical course will reduce mortality and hospital stay duration, thus reducing hospital costs. Keywords: Poisoning, emergency department, drug poisoning, suicide