Epidemiology, clinical characteristics, and associated cost of acute poisoning: a retrospective study from the emergency department of the largest referral hospital in Qatar

Abstract

AbstractIntroductionPoisoning is a major public health issue and a leading cause of admission to the emergency department (ED) worldwide. There is paucity of data describing epidemiology, outcomes, and cost of acute poisoning. Up-to-date information about poisoning pattern is imperative for accurate diagnosis and effective management. This study therefore investigates the epidemiology, poison pattern and associated cost of acute poisoning in Qatar.MethodA retrospective review of electronic health records of 397 patients admitted due to poisoning at the ED from January 2015 - December 2019. Demographic characteristics, incidence, clinical characteristics, cause of exposure, outcomes, and cost associated with acute poisoning were included. Frequency and percentages were calculated for categorical variable and mean and SD for continuous variables, relation between sociodemographic characters and poisoning profile was assessed using Chi-square. P-value less than 0.5 was considered statistically significant. A micro-costing approach using the cost of each resource was applied for the cost calculations.ResultThe incidence of acute poisoning was found to be 178 patients per 100,000 patients. Females (56%), and children below 14 years (44.3%) accounted for the largest proportion. The majority of the exposures were accidental and therapeutic agents (64.2%) were the most common toxic agents. The mean length of stay in the hospital was found to be 1.84 ± 0.81 and most patients (76.6) were discharged within the first 8 hours of the ED admission. A statistically significant difference was found between age groups and type of toxins (χ2 = 23.3, p < 0.001), cause and route of exposure (χ2 = 42.2, p < 0.001) and length of stay (χ2 = 113.16, p < 0.001). Admission to intensive care units had the highest cost expenditure (USD 326,008) while general wards accounted for the least (USD 57,709).ConclusionThe study demonstrates unintentional poisoning due to pharmacological agents was common among infants and children. The findings of this study will assist in the development of educational and preventative programs to minimise the exposure to toxic agents. Further studies exploring the impact of medical toxicology services, potential risk factors and post discharge monitoring of poisoning are highly warranted.