• Vol. 34 No. 5, 356–361
  • 15 June 2005

Review of Children Hospitalised for Ingestion and Poisoning at a Tertiary Centre

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ABSTRACT

Introduction: The main aim of this study is to determine the pattern of referrals of poisoning to a tertiary university hospital. The information will be used for poison prevention programme planning, and for educating and awareness promoting to the public. Materials and Methods: All patients (under 21 years of age) admitted to the paediatric wards between January 1997 and December 2002 with a discharge diagnosis indicating unintentional (UP) or intentional poisoning (IP) were identified through the computerised discharge information. Results: Sixty males and 98 females accounted for 161 admissions over the 6-year period. Their mean (standard deviation, SD) age was 8.2 (6.2) years. Sixty per cent of admissions involved UP. Females accounted for 47% of the UP but 86% of the IP [odds ratio of females for IP, 7.05; 95% confidence interval (CI) 2.95 to 17.28]. When compared with UP, IP patients were significantly older [mean (SD): 14.9 (1.7) versus 3.6 (3.3) years]. In 70% of the admissions, the patients ingested a single substance. Tablets and pills, especially in the IP adolescents, were more commonly ingested than syrups. The spectrum of substances ingested was vast but paracetamol, cough or cold medicines, and common adult household medications and agents accounted for the majority of medications ingested. The substances ingested were obtained at home in 81 cases (50%) and as over-the-counter medication in 33 (20%). The majority (92%) of patients presented within 24 hours of ingestion. On admission, 63% of UP and 45% of the IP were asymptomatic. No active treatment was required in 65% of patients. In IP, nearly 30% of IP who ingested paracetamol had toxic levels and received N-acteyl cysteine. A history of previous poisoning was more common and subsequent follow-up was offered to 74%. Conclusion: Young boys were more at risk of unintentional ingestion whereas adolescent girls were more likely to ingest medications as a gesture of suicide. Paracetamol is a frequently ingested medicinal for which an antidote is available.


Childhood ingestion and poisoning is an important problem in many countries,1-8 and accounts for a significant workload for emergency department consultations and hospital admissions.9,10 About 4 million people are poisoned in the United States every year. Children under 6 years of age account for 60% of these cases, and more young children die of poisoning at home than are accidentally killed by guns in the home.1,2,11,12 Poisoning is also recognised to be a significant hazard in early childhood in Australia.5,8 In New Zealand, mortality rates are lower than in many countries, but hospitalisation rates are higher.13 In Taiwan, the National Poison Center reported that childhood poisonings were underreported and of high mortality.14 However, the epidemiology and disease spectrum of childhood poisoning in Asian cities, including Hong Kong,15-20 has not been well characterised. Many paediatric ingestions are trivial and not referred to hospital for management.9,10,21 Nonetheless, assessing the epidemiology of paediatric ingestions admitted to hospital will provide important information for establishing the magnitude of the problem in the tertiary paediatric service. This study set out to describe the pattern of childhood ingestions admitted to a tertiary university hospital, and to compare the epidemiological characteristics of the unintentional (UP) and the intentional poisoning (IP) groups.

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