Description
The incidence of acute poisoning has been increasing in Fuzhou area in recent years. To evaluate the epidemiology and characteristics of acute poisoning, we retrospectively analyzed the data of 2867 patients with this poisoning who had been treated at the Emergency Center, Fujian Provincial Hospital, China from January 2004 to December 2009.
www.wjem.org
154 World J Emerg Med, Vol 1, No 2, 2010 Chen et al
© 2010 World Journal of Emergency Medicine
Epidemiology and characteristics of acute poisoning
treated at an emergency center
Feng Chen, Jun-ping Wen, Xiao-ping Wang, Qing-ming Lin, Cai-jing Lin
Emergency Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, China
Corresponding Author: Feng Chen, Email : [email protected]
BACKGROUND: Acute poisoning is frequently encountered at emergency department. This study
was to investigate the epidemiology and characteristics of patients with acute poisoning who were
treated at the Emergency Center, Fujian Provincial Hospital, China.
METHODS: We retrospectively analyzed the gender, age, causes of poisoning, types of poisons,
poisoning route, emergency diagnoses, outcomes, and prognoses of these patients.
RESULTS: Altogether 2867 patients with acute poisoning were treated from January 2004 to
December 2009. The ratio of male to female was 1:1.04, and their average age was 33.8 years. Of the
2867 patients, 76.39% were between 18 and 40 years old. The incidence of acute poisoning was as
high as 11.33% in January each year. The incidence of poisoning was in a descending order: alcohol
poisoning (54.55%), medication poisoning (25.95%), pesticide poisoning (5.65%), and drug poisoning
(4.88%). Most (56.44%) of the patients with drug poisoning were under 25 years and their mean age
was signi?cantly lower than that of patients with medication poisoning or alcohol poisoning (P < 0.01).
Approximately 69.54% of the patients were followed up after emergency treatment, 30.39% were
hospitalized, and four patients died.
CONCLUSIONS: Acute poisoning is largely alcohol poisoning and medication poisoning in a city.
The emergency green channel “pre-hospital emergency care-emergency department-hospital treatment”
can signi?cantly improve the survival rate of patients with acute poisoning.
KEY WORDS: Hospital-af?liated emergency center; Management model; Green channel; Acute
poisoning; Epidemiology, emergency care
World J Emerg Med 2010;1(2):154-156
Clinical summary
INTRODUCTION
The i nci dence of acut e poi soni ng has been
increasing in Fuzhou area in recent years. To evaluate the
epidemiology and characteristics of acute poisoning, we
retrospectively analyzed the data of 2867 patients with
this poisoning who had been treated at the Emergency
Center, Fujian Provincial Hospital, China from January
2004 to December 2009.
The data including gender, age, causes of poisoning,
types of poisons, poisoning route, emergency diagnoses,
outcomes, and prognoses of the patients were input into
a Microsoft Excel database for statistical analysis.
Of the 2867 patients 1408 were male and 1459
female, with a male to female ratio of 1:1.04. Their age
ranged from 14 to 93 years (mean 33.8 years). Patients of
18 to 40 years old accounted for 76.39% (Figure 1).
In 1564 patients (54.55%) with alcohol poisoning,
1025 (65.54%) were male, whereas in 744 patients
(25.95%) with medication poisoning, 600 (80.65%)
were female. Patients with pesticide poisoning and drug
poisoning accounted for 5.65% and 4.88% respectively.
In patients with drug poisoning, however, males were
more than females. There were other types of poisoning,
like chemical poisoning, food poisoning, rodenticide
poisoning, carbon monoxide poisoning, and phosgene
poisoning (Table 1).
www.wjem.org
155 World J Emerg Med, Vol 1, No 2, 2010
There was no significant difference in season
distribution. In month distribution, January showed
the highest incidence (11.33%), whereas March had
the lowest (6.35%). In the two most common types of
poisoning, alcohol poisoning occurred frequently in
January, and medication poisoning in May (Figure 2).
In the patients with alcohol poisoning, males
account ed for 65. 54%, whi l e i n t he medi cat i on
poisoning, females accounted for 80.65%. The mean
age of alcohol poisoning patients was 32.0 years, and
the patients aged ?25 years accounted for 32.74%. In
Type of poisoning Number of cases Percentage (%)
Alcohol 1564 54.55
Medication 744 25.95
Pesticide 162 5.65
Drug 140 4.88
Chemical 81 2.83
Food 60 2.09
Rodenticide 54 1.88
Carbon monoxide 53 1.85
Phosgene 7 0.24
Unknown 2 0.07
Total 2867 100
Table 1. Types of acute poisoning and number and percentage of cases
the patients with medication poisoning aged on average
33.0 years, 96.10% were given tranquilizers and in
the patients aged ?25 years, 40.86% were given the
same agents. The average age of the patients with drug
poisoning was 28.2 years, which was signi?cantly lower
than that of the patients with alcohol poisoning or those
with medication poisoning (P <0.01).
The gastrointestinal tract and respiratory tract
were the routes for poisons entering the body. Oral
administration and inhalation accounted for 95.44% and
4.35% respectively. Among the patients, 438 (15.28%)
were subjected to emesis treatment, 251 (8.75%) to
gastric lavage, 735 (25.64%) to diuresis, 1493 (52.08%)
to speci?c medications, and 94.33% to transfusion. Five
patients underwent endotracheal intubation because of
breathing difficulty caused by pesticide poisoning. One
patient underwent tracheotomy.
The severity of the poisoning was classified into
mild, moderate, or severe according to the conditions of
patients on admission. Altogether 28.94% of the patients
suffered from mild poisoning, 58.22% from moderate
poisoning, and 12.84% from severe poisoning. A total
of 871 patients were hospitalized, but 163 of them were
discharged home without treatment. In fact 1994 patients
(69.55%) were followed up after emergency care. Four
patients with pesticide poisoning died.
DISCUSSION
The incidence of acute poisoning has been increasing
in recent years in China. In the present study we
investigated the epidemiology and characteristics of
patients with acute poisoning who had been treated at the
Emergency Center, Fujian Provincial Hospital.
Female patients with acute poisoning were more than
male patients in this study, and female patients of 18-
Figure 1. Age and gender distribution of patients with acute poisoning.
18-19 30-39 40-49 50-59 60-69 70-79 >80
900
800
700
600
500
400
300
200
100
0
Age
N
u
m
b
e
r
o
f
c
a
s
e
s
Male
Female
Figure 2. The number of poisoning cases and types of poisonings in each month (alcohol and medication poisoning).
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
350
300
250
200
150
100
50
0
Month
N
u
m
b
e
r
o
f
c
a
s
e
s
Total
Alcohol
Medication
www.wjem.org
156 World J Emerg Med, Vol 1, No 2, 2010 Chen et al
40 years old accounted for 76.39%, which was similar to
that reported by Ruan et al.
[1]
The likely explanation was
that people at this age stage often face with pressures of
unemployment, working, love and marriage, and family
conflict. Moreover, acute poisoning is the third leading
cause of unexpected hospitalization of pregnant women.
[2]
It is proposed that sentiment volatility is also a reason for
female patients, such as acute poisoning caused by suicide
attempts.
[3,4]
In this study alcohol poisoning is predominent.
Al cohol abuse i s st i l l recogni zed as a common
phenomenon in modern society, and the age of patients
with alcohol poisoning is younger. In this study, the patients
with alcohol poisoning aged ? 25 years accounted for
32.74%. Hence it is crucial to strengthen public education
on healthy lifestyles. In addition, alcohol poisoning occurs
frequently in January, which may be connected with family
union during the Chinese New Year. Medication poisoning
we investigated is at the second position, and it is usually
caused by tranquilizers.
[5,6]
In recent years, the proliferation
of drugs is fairly brisk, and the drug abuse among young
people is increasing. In the present study, drug poisoning
was listed in the fourth position, and the mean age of
patients was 28.2 years, which was significantly lower
than that of patients with alcohol poisoning or medication
poisoning. Therefore it is necessary to educate young
people to keep away from drugs.
[7]
Since emergency
centers vary geographically, many patients with pesticide
poisoning from rural areas are usually transferred to
the centers, thus leading to a delayed treatment. In our
opinion, treatment of acute poisoning should follow the
principle of on spot treatment. Pesticides or herbicides
poisoning is still the leading cause of death in some areas
of China. Therefore it is crucial to strengthen training of
medical staff working at county-level hospitals and rural
health clinics.
At the emergency center of the Fujian Provincial
Hospital we treated timely the 2867 patients with acute
poisoning but 4 patients died from the severity of the
condition. The results show that emergency green
channel plays an important role in improving the quality
of acute poisoning treatment.
[8]
Funding: None.
Ethical approval: Not needed.
Con?icts of interest: No bene?ts in any form have been received
or will be received from a commercial party related directly or
indirectly to the subject of this article.
Contributors: Chen F proposed and wrote the study. All authors
contributed to the design and interpretation of the study and to
further drafts.
REFERENCES
1 Ruan HL, Yang CX. A study on epidemiology among emergency
patients in a comprehensive hospital with acute poisoning. Chin
Gener Pract 2006; 9: 141-143.
2 Weiss HB. Pregnancy-associated injury hospitalizations in
Pennsylvania, 1995. Ann Emerg Med 1999; 34: 626-636.
3 Wei F. Clinical investigation of 650 cases of acute intoxication.
Clin Misdiag Mistherapy 2008; 21: 18-19.
4 Zhou J, Chen S, Li Z, Wu YQ. Study of drug poisoning on 2612
cases in the department of emergency. J Hygiene Res 2005; 34:
98-100.
5 Li H, Wang X, Huang X. The characteristics of the acute
poisoning patients in emergency department of a general hospital
in a new emerging district. Chin J Emerg Med 2006; 15: 930-
932.
6 Zhang J, Liu X. Retrospective analysis of 1882 patients with
acute poisoning. Med Recapitulat 2007; 13: 959-961.
7 Wang Z, Lu X. Analysis on the monitoring data of drug abuse
in Shanxi Province between 2005 and 2008. Chin J Drug Abuse
Prevent and Treat 2009; 15: 346-350.
8 Lin CJ, Wei Z. Investigation on the pattern of hospital af?liated
emergency centre. Chin J Emerg Med 2003; 12: 355-356.
Received May 9, 2010
Accepted after revision July 23, 2010
doc_482355188.pdf
The incidence of acute poisoning has been increasing in Fuzhou area in recent years. To evaluate the epidemiology and characteristics of acute poisoning, we retrospectively analyzed the data of 2867 patients with this poisoning who had been treated at the Emergency Center, Fujian Provincial Hospital, China from January 2004 to December 2009.
www.wjem.org
154 World J Emerg Med, Vol 1, No 2, 2010 Chen et al
© 2010 World Journal of Emergency Medicine
Epidemiology and characteristics of acute poisoning
treated at an emergency center
Feng Chen, Jun-ping Wen, Xiao-ping Wang, Qing-ming Lin, Cai-jing Lin
Emergency Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, China
Corresponding Author: Feng Chen, Email : [email protected]
BACKGROUND: Acute poisoning is frequently encountered at emergency department. This study
was to investigate the epidemiology and characteristics of patients with acute poisoning who were
treated at the Emergency Center, Fujian Provincial Hospital, China.
METHODS: We retrospectively analyzed the gender, age, causes of poisoning, types of poisons,
poisoning route, emergency diagnoses, outcomes, and prognoses of these patients.
RESULTS: Altogether 2867 patients with acute poisoning were treated from January 2004 to
December 2009. The ratio of male to female was 1:1.04, and their average age was 33.8 years. Of the
2867 patients, 76.39% were between 18 and 40 years old. The incidence of acute poisoning was as
high as 11.33% in January each year. The incidence of poisoning was in a descending order: alcohol
poisoning (54.55%), medication poisoning (25.95%), pesticide poisoning (5.65%), and drug poisoning
(4.88%). Most (56.44%) of the patients with drug poisoning were under 25 years and their mean age
was signi?cantly lower than that of patients with medication poisoning or alcohol poisoning (P < 0.01).
Approximately 69.54% of the patients were followed up after emergency treatment, 30.39% were
hospitalized, and four patients died.
CONCLUSIONS: Acute poisoning is largely alcohol poisoning and medication poisoning in a city.
The emergency green channel “pre-hospital emergency care-emergency department-hospital treatment”
can signi?cantly improve the survival rate of patients with acute poisoning.
KEY WORDS: Hospital-af?liated emergency center; Management model; Green channel; Acute
poisoning; Epidemiology, emergency care
World J Emerg Med 2010;1(2):154-156
Clinical summary
INTRODUCTION
The i nci dence of acut e poi soni ng has been
increasing in Fuzhou area in recent years. To evaluate the
epidemiology and characteristics of acute poisoning, we
retrospectively analyzed the data of 2867 patients with
this poisoning who had been treated at the Emergency
Center, Fujian Provincial Hospital, China from January
2004 to December 2009.
The data including gender, age, causes of poisoning,
types of poisons, poisoning route, emergency diagnoses,
outcomes, and prognoses of the patients were input into
a Microsoft Excel database for statistical analysis.
Of the 2867 patients 1408 were male and 1459
female, with a male to female ratio of 1:1.04. Their age
ranged from 14 to 93 years (mean 33.8 years). Patients of
18 to 40 years old accounted for 76.39% (Figure 1).
In 1564 patients (54.55%) with alcohol poisoning,
1025 (65.54%) were male, whereas in 744 patients
(25.95%) with medication poisoning, 600 (80.65%)
were female. Patients with pesticide poisoning and drug
poisoning accounted for 5.65% and 4.88% respectively.
In patients with drug poisoning, however, males were
more than females. There were other types of poisoning,
like chemical poisoning, food poisoning, rodenticide
poisoning, carbon monoxide poisoning, and phosgene
poisoning (Table 1).
www.wjem.org
155 World J Emerg Med, Vol 1, No 2, 2010
There was no significant difference in season
distribution. In month distribution, January showed
the highest incidence (11.33%), whereas March had
the lowest (6.35%). In the two most common types of
poisoning, alcohol poisoning occurred frequently in
January, and medication poisoning in May (Figure 2).
In the patients with alcohol poisoning, males
account ed for 65. 54%, whi l e i n t he medi cat i on
poisoning, females accounted for 80.65%. The mean
age of alcohol poisoning patients was 32.0 years, and
the patients aged ?25 years accounted for 32.74%. In
Type of poisoning Number of cases Percentage (%)
Alcohol 1564 54.55
Medication 744 25.95
Pesticide 162 5.65
Drug 140 4.88
Chemical 81 2.83
Food 60 2.09
Rodenticide 54 1.88
Carbon monoxide 53 1.85
Phosgene 7 0.24
Unknown 2 0.07
Total 2867 100
Table 1. Types of acute poisoning and number and percentage of cases
the patients with medication poisoning aged on average
33.0 years, 96.10% were given tranquilizers and in
the patients aged ?25 years, 40.86% were given the
same agents. The average age of the patients with drug
poisoning was 28.2 years, which was signi?cantly lower
than that of the patients with alcohol poisoning or those
with medication poisoning (P <0.01).
The gastrointestinal tract and respiratory tract
were the routes for poisons entering the body. Oral
administration and inhalation accounted for 95.44% and
4.35% respectively. Among the patients, 438 (15.28%)
were subjected to emesis treatment, 251 (8.75%) to
gastric lavage, 735 (25.64%) to diuresis, 1493 (52.08%)
to speci?c medications, and 94.33% to transfusion. Five
patients underwent endotracheal intubation because of
breathing difficulty caused by pesticide poisoning. One
patient underwent tracheotomy.
The severity of the poisoning was classified into
mild, moderate, or severe according to the conditions of
patients on admission. Altogether 28.94% of the patients
suffered from mild poisoning, 58.22% from moderate
poisoning, and 12.84% from severe poisoning. A total
of 871 patients were hospitalized, but 163 of them were
discharged home without treatment. In fact 1994 patients
(69.55%) were followed up after emergency care. Four
patients with pesticide poisoning died.
DISCUSSION
The incidence of acute poisoning has been increasing
in recent years in China. In the present study we
investigated the epidemiology and characteristics of
patients with acute poisoning who had been treated at the
Emergency Center, Fujian Provincial Hospital.
Female patients with acute poisoning were more than
male patients in this study, and female patients of 18-
Figure 1. Age and gender distribution of patients with acute poisoning.
18-19 30-39 40-49 50-59 60-69 70-79 >80
900
800
700
600
500
400
300
200
100
0
Age
N
u
m
b
e
r
o
f
c
a
s
e
s
Male
Female
Figure 2. The number of poisoning cases and types of poisonings in each month (alcohol and medication poisoning).
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
350
300
250
200
150
100
50
0
Month
N
u
m
b
e
r
o
f
c
a
s
e
s
Total
Alcohol
Medication
www.wjem.org
156 World J Emerg Med, Vol 1, No 2, 2010 Chen et al
40 years old accounted for 76.39%, which was similar to
that reported by Ruan et al.
[1]
The likely explanation was
that people at this age stage often face with pressures of
unemployment, working, love and marriage, and family
conflict. Moreover, acute poisoning is the third leading
cause of unexpected hospitalization of pregnant women.
[2]
It is proposed that sentiment volatility is also a reason for
female patients, such as acute poisoning caused by suicide
attempts.
[3,4]
In this study alcohol poisoning is predominent.
Al cohol abuse i s st i l l recogni zed as a common
phenomenon in modern society, and the age of patients
with alcohol poisoning is younger. In this study, the patients
with alcohol poisoning aged ? 25 years accounted for
32.74%. Hence it is crucial to strengthen public education
on healthy lifestyles. In addition, alcohol poisoning occurs
frequently in January, which may be connected with family
union during the Chinese New Year. Medication poisoning
we investigated is at the second position, and it is usually
caused by tranquilizers.
[5,6]
In recent years, the proliferation
of drugs is fairly brisk, and the drug abuse among young
people is increasing. In the present study, drug poisoning
was listed in the fourth position, and the mean age of
patients was 28.2 years, which was significantly lower
than that of patients with alcohol poisoning or medication
poisoning. Therefore it is necessary to educate young
people to keep away from drugs.
[7]
Since emergency
centers vary geographically, many patients with pesticide
poisoning from rural areas are usually transferred to
the centers, thus leading to a delayed treatment. In our
opinion, treatment of acute poisoning should follow the
principle of on spot treatment. Pesticides or herbicides
poisoning is still the leading cause of death in some areas
of China. Therefore it is crucial to strengthen training of
medical staff working at county-level hospitals and rural
health clinics.
At the emergency center of the Fujian Provincial
Hospital we treated timely the 2867 patients with acute
poisoning but 4 patients died from the severity of the
condition. The results show that emergency green
channel plays an important role in improving the quality
of acute poisoning treatment.
[8]
Funding: None.
Ethical approval: Not needed.
Con?icts of interest: No bene?ts in any form have been received
or will be received from a commercial party related directly or
indirectly to the subject of this article.
Contributors: Chen F proposed and wrote the study. All authors
contributed to the design and interpretation of the study and to
further drafts.
REFERENCES
1 Ruan HL, Yang CX. A study on epidemiology among emergency
patients in a comprehensive hospital with acute poisoning. Chin
Gener Pract 2006; 9: 141-143.
2 Weiss HB. Pregnancy-associated injury hospitalizations in
Pennsylvania, 1995. Ann Emerg Med 1999; 34: 626-636.
3 Wei F. Clinical investigation of 650 cases of acute intoxication.
Clin Misdiag Mistherapy 2008; 21: 18-19.
4 Zhou J, Chen S, Li Z, Wu YQ. Study of drug poisoning on 2612
cases in the department of emergency. J Hygiene Res 2005; 34:
98-100.
5 Li H, Wang X, Huang X. The characteristics of the acute
poisoning patients in emergency department of a general hospital
in a new emerging district. Chin J Emerg Med 2006; 15: 930-
932.
6 Zhang J, Liu X. Retrospective analysis of 1882 patients with
acute poisoning. Med Recapitulat 2007; 13: 959-961.
7 Wang Z, Lu X. Analysis on the monitoring data of drug abuse
in Shanxi Province between 2005 and 2008. Chin J Drug Abuse
Prevent and Treat 2009; 15: 346-350.
8 Lin CJ, Wei Z. Investigation on the pattern of hospital af?liated
emergency centre. Chin J Emerg Med 2003; 12: 355-356.
Received May 9, 2010
Accepted after revision July 23, 2010
doc_482355188.pdf