Retrospective Analysis on the Clinical Differences of Children and Adolescents Treated for Acute Pediatric Poisoning in an Emergency Department?

Abstract

Purpose: This study reports the clinical features of children and adolescents treated for acute poisoning at a regional emergency department (ED). Methods: We retrospectively analyzed children and adolescents (under 19 years) treated for poisoning in an emergency department (ED) from 2003 to 2012. Children range from 0 to 10 years and adolescents range from 11 to 18 years. Demographic data, poisonous material data, treatment, and outcome from poisoning were collected. Results: There were 742 cases of pediatric poisoning during the study period. The distribution of patient ages was bimodal, with two peaks during 1~2 years and 17~18 years of age. The proportion of adolescents with acute poisoning increased from 22.7% (years 2003~2007) to 38% (years 2008~2013). Among children less than 11 years of age, various poisonous agents and therapeutic drugs comprised 43.9% of the total toxic substance subtypes. However, four types of toxic substances dominated among adolescents: acetaminophen, carbon monoxide, corrosives, and psychiatric drugs. Overall, 54.6% of acute intoxicated patients were asymptomatic (17.7% in adolescents). In addition, 25.8% of patients who wer children were not medically treated compared to 2.8% of adolescent patients. Gastric lavage, charcoal usage, and antidote therapy were performed more often in adolescents and enhanced elimination was only performed in adolescents. The discharge rate from the emergency department was 86.8% for children and 69.1% for adolescents. Also, 4.8% of adolescents were admitted into an intensive care unit but no patients died. Conclusion: The incidence of adolescent poisoning increased during the period examined. There were many clinical differences in acute poisoning between children and adolescents. Therefore, strategies to cope with acute poisoning according to age group are required.