Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 22 , ISSUE 10 ( 2018 ) > List of Articles

RESEARCH ARTICLE

Clinical profile and outcome of patients with acute poisoning admitted in intensive care unit of tertiary care center in Eastern Nepal

Lalit Rajbanshi, Batsalya Arjyal, Rakesh Mandal

Keywords : Acute poisoning, intensive care unit, mortality, organophosphorous

Citation Information : Rajbanshi L, Arjyal B, Mandal R. Clinical profile and outcome of patients with acute poisoning admitted in intensive care unit of tertiary care center in Eastern Nepal. Indian J Crit Care Med 2018; 22 (10):691-696.

DOI: 10.4103/ijccm.IJCCM_207_18

License: CC BY-ND 3.0

Published Online: 01-10-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Acute poisoning is a common health-care problem requiring admission in the intensive care unit (ICU) in the developing countries. The study was conducted to assess the epidemiological parameters of acute poisoning and factors affecting clinical course and outcome of the patients in ICU in the eastern part of Nepal. Methodology: This was a prospective observational study conducted at ICU of tertiary care hospital in the eastern part of Nepal for the duration of 2 years. All the acute poisoning cases admitted in the ICU were studied for epidemiological profiles, poisoning characteristics, and various clinical factors affecting the outcome of the patients. Results: Eighty-five patients with acute poisoning were included in the study. Suicidal attempt leading to acute poisoning was seen in majority of the young population. Majority of the poisoning was due to the organophosphorous compounds (43.5%). Patients with organophosphorous poisoning had a significantly longer duration of ICU stay (P = 0.020). The survival of the patients was significantly affected by age, duration of presentation to the hospital, Glasgow Coma Scale, Sequential Organ Failure Assessment score, need for mechanical ventilation, duration of ICU stay, hepatic failure, coagulopathy, and need for vasoactive drugs (P < 0.05). The independent predictors of mortality observed in the study were age, delayed presentation to the hospital, hepatic failure, and need for mechanical ventilation. Conclusion: Organophosphorous poisoning was the most common acute poisoning in young population leading to the ICU admission. Older age, delayed initiation of the resuscitative measures, need for mechanical ventilation, and hepatic failure significantly affected the mortality.


PDF Share
  1. Konradsen F, Dawson AH, Eddleston M, Gunnell D. Pesticide self-poisoning: Thinking outside the box. Lancet 2007;369:169-70.
  2. Thundiyil JG, Stober J, Besbelli N, Pronczuk J. Acute pesticide poisoning: A proposed classification tool. Bull World Health Organ 2008;86:205-9.
  3. Eddleston M, Buckley NA, Eyer P, Dawson AH. Management of acute organophosphorus pesticide poisoning. Lancet 2008;371:597-607.
  4. Marecek J. Culture, gender, and suicidal behavior in Sri Lanka. Suicide Life Threat Behav 1998;28:69-81.
  5. McClure GM. Suicide in children and adolescents in England and wales 1970-1998. Br J Psychiatry 2001;178:469-74.
  6. Singh O, Javeri Y, Juneja D, Gupta M, Singh G, Dang R, et al. Profile and outcome of patients with acute toxicity admitted in intensive care unit: Experiences from a major corporate hospital in urban India. Indian J Anaesth 2011;55:370-4.
  7. Ahuja H, Mathai AS, Pannu A, Arora R. Acute poisonings admitted to a tertiary level Intensive Care Unit in Northern India: Patient profile and outcomes. J Clin Diagn Res 2015;9:UC01-4.
  8. Mishra A, Shukla SK, Yadav MK, Gupta Ak. Epidemiological study of medicolegal organophosphorus poisoning in central region of Nepal. J Forensic Res 2012;3:1-5.
  9. Dhakal AK, Shrestha D, Shakya A, Shah SC, Shakya H. Clinical profile of acute poisoning in children at a teaching hospital in Lalitpur. J Nepal Paediatr Soc 2014;34:100-3.
  10. Abdollahi M, Jalali N, Sabzevari O, Hoseini R, Ghanea T. A retrospective study of poisoning in Tehran. J Toxicol Clin Toxicol 1997;35:387-93.
  11. Zaheer MS, Aslam M, Gupta V, Sharma V, Khan SA. Profile of poisoning cases at a North Indian tertiary care hospital. Health Popul Perspect Issues 2009;32:176-83.
  12. Gannur DG, Maka P, Narayan Reddy KS. Organophosphorus compound poisoning in Gulbarga region – A five year study. Indian J Forensic Med Toxicol 2008;2:3-11.
  13. Nigam M, Jain AK, Dubey BP, Sharma VK. Trends of organophosphorus poisoning in Bhopal region an autopsy based study. JIAFM 2004;26:62-5.
  14. Chintale KN, Patne SV, Chavan SS. Clinical profile of organophosphorus poisoning patients at rural tertiary health care centre. Int J Adv Med 2016;3:268-74.
  15. Ramesha KN, Rao KB, Kumar GS. Pattern and outcome of acute poisoning cases in a tertiary care hospital in Karnataka, India. Indian J Crit Care Med 2009;13:152-5.
  16. Das RK. Epidemiology of insecticide poisoning at A.I.I.M.S emergency service and role of its detection by gas liquid chromatographyin diagnosis. Medicoleg Update 2007;7:49-60.
  17. Padmanabha TS, Gumma K, Kulkarni GP. Study of profile of organophpsphorus poisoning cases in a tertiary care hospital, North Karnataka, India. Int J Bio Sci 2014;5:332-9.
  18. Giyanwani PR, Zubair U, Salam O, Zubair Z. Respiratory failure following organophosphate poisoning: A literature review. Cureus 2017;9:e1651.
  19. Boukatta B, El Bouazzaoui A, Guemoune R, Houari N, Achour S, Sbai H. An epidemiological study of adult acute poisoning in Fez: Morocco. J Clin Toxicol 2014;4:1-5.
  20. Joshi M, Patel DV. A study on clinical profile of patients with acute poisoning. GCSMC J Med Sci 2015;4:97-100.
  21. Mathai A, Bhanu MS. Acute aluminium phosphide poisoning: Can we predict mortality? Indian J Anaesth 2010;54:302-7.
  22. Louriz M, Dendane T, Abidi K, Madani N, Abouqal R, Zeggwagh AA, et al. Prognostic factors of acute aluminum phosphide poisoning. Indian J Med Sci 2009;63:227-34.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.