INVESTIGATING POISONING INCIDENTS: PATTERNS, CONTRIBUTING FACTORS, AND CLINICAL OUTCOMES REPORTED IN THE EMERGENCY DEPARTMENT OF A TERTIARY CARE HOSPITAL, KARACHI, PAKISTAN
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Keywords
Frequency, pattern, associated factors, poisoning cases, Pakistan
Abstract
Objective: This study aimed to determine the frequency, patterns, factors, and clinical outcomes associated with poisoning cases reported in a tertiary care hospital's emergency department (ED) in Karachi, Pakistan.
Study Design: Cross-sectional study
Place and duration of study: Emergency Medicine Department, Dow University Hospital, Karachi, Pakistan from March to August 2024.
Methodology: A total of 220 poisoning cases were included aged 18-70 years of both genders and who visited the ED of the study setting. Data was gathered through a pre-designed questionnaire. Patients were followed during ED stay, inpatient services, and till discharge.
Results: Over half of the cases took 1 to 5 hours to reach the hospital (n=166, 75.5%), 80.5% (n=177) had an oral route of poison administration, and most of them were poisoned with household chemicals (n=40, 18.2%), with low SES being major reason (n=19, 8.6%). Most had left against medical advice (LAMA) as their clinical outcome (n=102, 46.4%). Regarding association, it was found that most patients who reached the hospital after one hour (p-value=0.033), those who were drug overdosed (p-value=0.002), who ingested opioids (p-value=0.000) were strongly associated with the clinical outcome.
Conclusion: The findings indicate that younger males from lower socioeconomic backgrounds were at higher risk, with household chemicals and pharmaceuticals being the most common poisoning agents. The study also highlighted critical issues such as delayed hospital arrival and a high rate of patients leaving against medical advice (LAMA), which negatively impact clinical outcomes.
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Dr Raheela Irshad
Lecturer, Department of Forensic Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
Dr Ramlah Naz
Professor, Department of Forensic Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
Dr Syed Maaz Salahuddin
Assistant Professor, Department of Emergency Medicine, Dow International Medical, College, Dow University of Health Sciences, Karachi, Pakistan
Dr Mehreen Fatima
Associate Professor, Department of Forensic Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
Dr Gulzar Ali
Medico Legal Officer Civil Hospital Karachi/SMBB Trauma Centre Institute. Office of the Police Surgeon Karachi Sindh Pakistan
Dr Raffat Rasool
Assitant Professor Department of Forensic Medicine, Karachi Medical &Dental College, Karachi, Pakistan