Is Poisoning by Oral Therapeutic Drugs more Severe? a Retrospective Study on Unintentional Paediatric Poisoning in a Local Emergency Hospital

Abstract

Introduction Paediatric unintentional poisoning is a common presenting problem in the emergency department. Our study aim to determine whether poisoning caused by oral therapeutic drugs was more severe and causing longer hospital stay. We also aim to review the recent local epidemiology of unintentional paediatric poisoning in Hong Kong. Methods We conducted a retrospective review on all consecutive cases of patients aged 0-9 who presented to the emergency department during a study period from 1st January 2006 to 31st December 2007 with unintentional poisoning. Demographic data, clinical presentation, poisoning agent involved, intervention performed and the clinical outcome were analysed. The clinical outcomes of poisoning due to oral therapeutic drugs versus other chemicals were compared. Results Sixty one poisoning episodes were included. The most common type of agents involved was oral therapeutic drugs (52.5%); followed by cleaning products and detergents (14.8%). Most cases were benign, 63.9% of the cases showed no clinical and biochemical poisoning effect without any treatment. Poisoning due to oral therapeutic drugs were more severe, 12.5% were classified as poisoning with major effect that required active treatment while no cases of severe poisoning were found in poisoning caused by other chemicals. Significantly fewer cases (40.6%) were classified as no or mild effect in the group caused by oral drugs, compared with those caused by other chemicals (86.2%) (p=0.001). The mean length of stay was also significantly longer in the group with oral drugs (1.7 days) compared with 0.9 days in other chemicals (p=0.047). Conclusions In our locality, severe unintentional poisonings were usually due to oral therapeutic drugs. For prevention planning, we should focus on the safety placement of oral medications of family members.