Pattern of Acute Poisoning and Drug Overdose Cases in the Emergency Department of a Tertiary Care Hospital: An Observational Study

TL;DR

This study examines the patterns of acute poisoning and drug overdose cases in Nepal, highlighting insecticides as the main cause and the vulnerability of females and young adults.

Contribution

The study provides insights into the specific toxicological challenges in Nepal, including the role of wild honey and insecticides in poisoning cases.

Findings

Insecticides were the most common agents in both accidental and intentional poisoning cases.

Females were more affected in both accidental and intentional poisoning cases.

Wild honey poisoning was prevalent among older adults.

Abstract

Acute poisoning and drug overdose cases are common to emergency department visits worldwide, with variation according to regional factors. In Nepal, easy availability to agricultural chemicals and locally sold toxins such as wild honey present specific toxicological challenges. This study aims to observe the patterns of poisoning and drug overdose cases in a tertiary care hospital, including the distribution of accidental and intentional self-harm cases, types of poisoning agents, demographic characteristics, and clinical outcomes.

A descriptive cross-sectional study was conducted from March 1 to November 30, 2024, at Nepal Medical College and Teaching Hospital after receiving ethical clearance (Ref. No. 41-080/081). All poisoning cases presented with acute poisoning or drug overdose during that time period were included. Data on age, gender, type of poison, and outcomes were compiled and analyzed using SPSS version 16. Descriptive statistics was applied.

Among 215 cases, 192 (89.30)% were accidental and 23 (10.70%) were intentional self-harm. Females accounted for 102 (53.10%) of accidental poisonings and 16(69.60%) of intentional self-harm cases. A total of 104 (48.40%) patients were in the age group of 19-39 years. Insecticides were the most common agents in both accidental 65 (33.90%) and intentional 12(52.20%) cases. Wild honey poisoning made up 23 (12%) of accidental exposures, especially in older adults. Hospitalization was required in 98 (51%) of accidental and 14 (60.90%) of intentional cases. Around 89 (41.39%) of patients left against medical advice. Mortality was low 2 (1%), narrowed to accidental cases only.

The predominance of insecticide poisoning, female vulnerability, and the concentration of cases among young adults is alarming.