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Epidemiology ofdeliberate self-poisoning patients in the emergency department
INTRODUCTION : Deliberate self‐poisoning (DSP) is a commoncause of adult suicide attempt particularly in developing countries and it is important to study its various epidemiological manifestations with clear definitions. The objective of this study was to assess the epidemiology of deliberate self-poisoning presentations inpatients seen in the emergency department
(ED).
METHODS : Prospective and monocentric study from April 2012 to March 2016. Patients over 15 years of age with a diagnosis of acute self-poisoning were included. Accidental poisoning, caustic ingestion, alcohol and carbon monoxide (CO) poisoning were not included. The demographics, co-morbidities, clinical, biological data and in-hospital procedures were collected.
RESULTS : During the study period, 290 patients were enrolled.Mean age was 26±10 years. Sex ratio was 0.22. The median delay of consultation after ingestion was two hours. Patients had psychiatric history in 29.3% of cases of which 68 committed previous suicide attempt and 14 had a history of previous ICU admission for DSP. The o&ending toxic was a drug in 87% and a pesticide in 13% of cases. The initial examination showed n(%): consciousness disorders 53 (18.3) with coma in 25 (8.6), digestive disorders 93 (32) and hypotension (<90mmHg) 22 (7.6) of which 6 (2) had peripheral hypoperfusion signs. The toxidrome was identified in 91 patients n(%): anticholinergic 25 (8.6), cholinergic 21 (7.2), muscle relaxant 18 (6.2), opioid 10 (3.4), adrenergic 7 (2.4) and membrane stabilizer 3 (1). The initial management in ED was n(%): digestive decontamination in 133 (46), antidote in 40 (13.8), intubation in 38 (13) and vasoactive drugs in 6 (2). No deaths were noted in ED. Seventy two patients (25%) were admitted in ICU.
CONCLUSION : The epidemiologic profile of deliberate self-poisoning found through the study objectified young woman with psychiatric history having a pesticide poisoning. This patient profile shows the importance of psychiatric assessment of DSP patients which may reduce the rate of recurrence.
Key words : Deliberate self-poisoning, intensive care unit, emergency.
Epidemiology ofdeliberate self-poisoning patients in the emergency department
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