# Risk Factors and Outcomes of Pediatric Poisoning: A Cross-Sectional Study From a Tertiary Care Hospital in Peshawar, Pakistan

## TL;DR

This study examines the causes and outcomes of poisoning in children under 14 in Pakistan, finding that most cases involve young children at home and highlight the need for prevention strategies.

## Contribution

The study provides new insights into the risk factors and outcomes of pediatric poisoning in a lower-middle-income country context.

## Key findings

- Most poisoning cases occurred in children under three years old and at home.
- Organophosphorus compounds, medications, and petroleum products were the most common agents involved.
- Despite high hospitalization rates, multivariate analysis showed no significant predictors of mortality.

## Abstract

Background: Pediatric poisoning is a common and potentially life-threatening issue in lower-middle-income countries like Pakistan. It often goes unnoticed in households with young children and accounts for a substantial number of emergency department (ED) visits.

Objective: This study aims to identify the risk factors and common agents of acute poisoning in children and to determine their outcomes.

Materials and methods: In this cross-sectional study, the records of children under 14 years of age who presented to the pediatric ED with a history of poisoning within the preceding 48 hours were reviewed. The study period spanned from January 1, 2024, to December 31, 2024. A total of 154 patients were included. Data recorded included age, gender, poisoning agent, route, mode, and place of poisoning; whether the child was hospitalized or discharged after observation; length of stay; intensive care unit (ICU) admission; need for organ support; and hospitalization outcomes. All analyses were performed using SPSS Statistics version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.). Risk factors for adverse outcomes were assessed using the Chi-square test or Fisher’s exact test, as appropriate. A p-value below 0.05 was considered statistically significant.

Results: Of the 154 patients, the majority (74.7%, n = 115) were under the age of three years, and most were hospitalized (88.3%, n = 136). All poisoning cases involved accidental ingestion, with the majority occurring at home (96.1%, n = 148). Organophosphorus compounds were the most common poisoning agents (27.9%, n = 43), followed by medications (26.6%, n = 41) and petroleum products (17.5%, n = 27). Most patients (80.9%, n = 110) remained hospitalized for up to three days, with a mean duration of stay of 2.8 ± 1.8 days. The majority of hospitalized patients survived (87.5%, n = 119). Although length of stay, ICU admission, and need for organ support were significantly associated with mortality in univariate analysis, none were significant predictors of mortality in multivariate analysis: length of stay (AOR: 1.54; 95% CI: 0.27-8.86; p = 0.631), ICU admission (AOR: 0.967; 95% CI: 0.05-18.64; p = 0.982), and organ support (AOR: 14.04; 95% CI: 0.55-358.32; p = 0.110).

Conclusions: Pediatric poisoning predominantly affects children under the age of three years, with most incidents occurring at home. Organophosphates, medications, and petroleum products were the most commonly involved agents. High rates of hospitalization and mortality highlight the severity of the issue. To mitigate this problem, there is a pressing need for parental education, childproofing measures at home, and improved healthcare infrastructure to prevent poisoning incidents and enhance patient outcomes.