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A Prospective Observational Study on Pattern, Severity and Outcome of Different Poisoning Cases in a Tertiary Care Hospital, India

Author(s): Dr Vijay H Mate*, Dr Priti P Dhande, Dr Satish B Gonarkar and Dr Vijaya A Pandit

Introduction: The severity and outcome in poisoning cases are determined by multiple factors including poison characteristics, mode and amount of poisoning as well as treatment opportunity.

Methods: This is a prospective observational study conducted in emergency medicine department of a tertiary care hospital. The study included 88 poisoning and 11 snake bite cases. Data regarding demographics, mode of poisoning, lag time in treatment, first aid, outside and indoor treatment, co-morbid illness, duration of hospitalization and final outcome were collected in a pre-structured proforma. Logistic regression and univariate analysis were used to predict the effect of different variables on the outcome by using Mann-Whitney U/Fisher’s Exact test. All the analyses were carried out using SPSS (version 18.0).

Results: Incidence of poisoning and snakebites had a preponderance of males(p<0.001). Majority of poisonings were organophosphorus compounds and alcohol intoxication. Duration of hospital stay reduced in patients who had less lag time in reaching the hospital (p=0.032) whereas higher Poison Severity Score (PSS)(p<0.001) and code blue activation(p<0.001) prolonged hospital stay. Chances of survival increased with early blue code activation(p<0.001) and worsened with higher PSS(p<0.001) and more lag time (p<0.014).

Conclusion: OP compounds and alcoholic intoxication were the most common poisons. Provision for reducing lag time and early treatment at initial stage of poisoning or snake bite is effective in reducing duration of hospitalization and possibly mortality. Educational and awareness programs, establishment of poison information and surveillance centers and regulations on pesticides/drug availability will form important strategies for the prevention of these emergencies.

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