儿童时期需要重症监护的急性中毒和隐藏的威胁,自杀企图:单一中心的体验

A. Oto, S. Kılıç, M. Sahin
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摘要

目的:很少有研究对需要重症监护的儿科患者的中毒情况进行了研究,包括年龄组和毒性因子。这项研究将通过比较我们地区的数据与世界其他地区的数据,支持制定预防中毒措施的战略。方法:本研究为单中心回顾性研究。在2017年11月至2022年3月期间需要重症监护住院治疗的1个月至18岁的儿科患者中定义了急性中毒的基线状态。结果:急性中毒住院148例(5.2%),女性69.6%,中位年龄13.6个月。我们的研究表明,儿童急性中毒主要由药物(88.5%)、口服(97.3%)和家庭(85.8%)引起。我们观察到,中毒在两个不同的年龄达到顶峰;第一高峰出现在学龄前(33.1%),第二高峰出现在青春期(58.7%)。在单因素分析中,女性(优势比[OR]=4.1)、青少年(OR=167.6)、精神药物使用者(OR=55.5)和多种药物中毒(OR=3.6)与更多的自杀相关。在多变量分析中,青少年和使用精神药物对自杀企图有显著影响(OR=145.3和OR=37.9)。没有一个病人死亡。结论:预防中毒和自杀企图是最重要的优先事项。然而,我们建议即使没有观察到死亡率,也应加强预防策略。此外,我们的研究表明,自杀企图很可能会重复,特别是如果存在潜在的精神疾病。
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Acute poisonings requiring intensive care in childhood and a hidden threat, suicide attempts: a single-center experience
Objectives: Very few studies have been conducted to identify the conditions that cause poisoning in pediatric patients needing intensive care, both by age group and toxic agent factor. This study will support the development of strategies for poisoning prevention measures by comparing the data in our region with other data in the world. Methods: This study is a single-centered, retrospective study. The baseline status of acute poisoning was defined in pediatric patients aged one month to 18 years who required intensive care hospitalization between November 2017 and March 2022. Results: There were 148 patient admissions due to acute poisonings (5.2% of all admissions, 69.6% females, median age: 13.6 months). Our study revealed that acute poisoning in children is caused mainly by pharmacological (88.5%), oral intake (97.3%) and at home (85.8%). It was observed that intoxication peaked at two different ages; the first peak was at preschool (33.1%), and the second peak was at adolescence (58.7%). In the univariate analysis, females (odds ratio [OR]=4.1), adolescents (OR=167.6), psychiatric drug users (OR=55.5), and multiple drug intoxications (OR=3.6) were associated with more suicides. Being adolescents and using psychiatric medication contributed significantly to suicide attempts in multivariate analysis (OR=145.3 and OR=37.9). None of our patients died. Conclusions: Preventing both poisoning and suicide attempts is the most critical priority. However, we suggest prevention strategies should be strengthened even if mortality is not observed. Furthermore, our study shows that suicide attempts are very likely to be repeated, especially if an underlying psychiatric illness exists.
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