Drug Poisonings among Patients Presenting to the Emergency Department of a Tertiary Care Center in Eastern Nepal: An Observational Study

TL;DR

This study examines drug poisoning cases in Nepal's emergency department, finding that most incidents are intentional and involve benzodiazepines and analgesics, primarily among young women.

Contribution

The study provides insights into drug poisoning patterns in a tertiary care center in Eastern Nepal, focusing on demographics and substance types.

Findings

Intentional self-poisoning was the main cause, with benzodiazepines and analgesics being the most common substances.

Most patients recovered with supportive care, and the mortality rate was low.

Females accounted for the majority of cases, highlighting a gender disparity in drug poisoning incidents.

Abstract

Drug poisoning is a major public health concern contributing to emergency visits and hospital admissions. Understanding the patterns and characteristics of drug poisoning cases is crucial for developing targeted prevention strategies, improving early recognition, guiding appropriate clinical management, and informing public health policies to reduce morbidity and mortality. This study aimed to determine the prevalence and pattern of drug poisoning cases presenting to the Emergency Department of a tertiary care center in Eastern Nepal.

A prospective observational study was conducted in the Emergency Department of a tertiary care hospital from 1 January to 31 December 2022, after ethical approval (Ref. No: IRC/1466/018). Data from 60 eligible patients were collected using a structured proforma including socio-demographics, type and route of drug exposure, intent (accidental or suicidal), time of presentation, clinical features, management, and short-term outcomes. Descriptive statistics were used for analysis.

Among 30,019 emergency admissions, 60 (0.20%) were due to drug poisoning, with 38 (63.33%) cases accounting for females. Intentional self-poisoning occurred in 59 (98.33%) cases, while 1 (1.67%) case was accidental. Among the reported cases, 21 (35.00%) cases involved the use of CNS depressants (benzodiazepines), 18 (30.00%) cases involved analgesics, and 2 (3.33%) cases involved antidepressant use. There were 13 (21.76%) patients who presented within six hours of ingestion and received timely supportive care. There was 1 (1.67%) case of mortality.

Intentional self-poisoning was the predominant form of drug poisoning, mainly involving benzodiazepines and analgesics among young females. Most patients recovered with supportive management, and the case fatality rate was low.