Citation

Charra B, Hachimi A, Benslama A, Motaouakkil S. Annales de Toxicologie Analytique 2013; 25(1): 7-11.

Copyright

(Copyright © 2013)

DOI

10.1051/ata/2013030

PMID

unavailable

Abstract

Background and objective: Severe acute poisonings are a frequent aetiology of admission to emergency departments and intensive care. The aim of this retrospective study was to analyze the epidemiological profile of severe acute intoxications and highlight the prognostic factors in a medical intensive care unit.

METHODS: We analyzed data from 214 patients admitted to a medical ICU with acute poisoning between January 2006 and December 2010. Demographic and epidemiological data, severity scores (Simplified severity index (SAPS II), acute physiology and chronic health evaluation (APACHE II), poisoning severity score (PSS)), and outcome were collected.

RESULTS: One hundred twenty nine (60.3%) patients were females and majority (36%) of admissions were from age group 21 to 30 years. The most common agents were organophosphates 41.6%, followed by drug 27.1% and paraphenylene diamine 21.5%. Commonest mode of toxicity was suicidal (86.4%). The median time to treatment was 4 h [IQ:1-10]. The average length of stay was 7 ± 3 days. The ICU mortality rate was 22% whose principal cause was cardiogenic shock in 53.2% of cases. Independent prognostic factors are the PSS ≤ 2 (OR: 0.11; CI95%: 0.049-0.237; p < 0.001), the PPD poisoning (OR: 13.95; CI95%: 5.22-37.31; p < 0.001) and nosocomial infection (OR: 7.20; CI 95%: 1.94-6.7; p = 0.003).

CONCLUSION: The PSS ≤ 2, the PPD poisoning and the nosocomial infection are independent prognostic factors. Prevention at different levels and support for suicidal people are the effective measures against this phenomenon.

Language: fr

Keywords

adult; human; suicide; Toxicology; organophosphate; Mortality; female; male; prognosis; mortality; treatment outcome; disease severity; intoxication; article; major clinical study; acute disease; intensive care; drug; Acute poisoning; hospital infection; cardiogenic shock; Prognostic; n,n,n',n' tetramethyl 1,4 phenylenediamine; Medical intensive care unit