Severe acute poisoning among adolescents in Beijing: a 3-year retrospective cohort study at a tertiary referral center (2021–2023)

TL;DR

A study in Beijing found that most adolescent poisoning cases were intentional and linked to mental health issues, highlighting the need for better mental health support and regulation of toxic substances.

Contribution

This study provides new insights into the epidemiology and risk factors of acute poisoning among adolescents in Beijing, emphasizing mental health and toxic agent accessibility.

Findings

Pharmaceutical poisoning was the most common type, with a high association with preexisting psychiatric disorders.

Intentional self-harm was the primary cause of poisoning, predominantly among females.

Adverse outcomes were rare but linked to herbicide exposure and multi-agent poisonings.

Abstract

This study aimed to characterize the epidemiological features, management, and outcomes of acute poisoning among adolescents in Beijing and surrounding areas to guide targeted prevention and clinical intervention.

A retrospective cohort study was conducted among adolescents (aged 11–18 years) admitted for acute poisoning to the emergency or pediatric department of a tertiary toxicological referral center in Beijing between January 2021 and December 2023. Data on demographics, exposure characteristics, toxic agents, treatments, and clinical outcomes were collected and analyzed.

Among the 915 included cases, there was a significant female predominance (72.5%). Intentional self-harm accounted for the vast majority of incidents (94.5%), with oral ingestion being the primary route (99.5%). A high prevalence of preexisting psychiatric disorders was observed (60.1%). Pharmaceutical poisoning was the most common type (78.1%), followed by pesticides (12.5%). Common interventions included gastrointestinal decontamination (55.7%), extracorporeal elimination (22.3%), and antidote administration (3.1%). While most cases resulted in favorable outcomes (98.7%), adverse outcomes occurred in 1.3% of cases and were primarily associated with herbicide exposure. Logistic regression identified younger age, prehospital interventions, preexisting neuropsychiatric disorders, pesticide exposure, multi-agent mixed exposures, industrial chemical poisoning, and intentional self-harm as significant predictors of hospitalization.

The findings underscore the critical importance of strengthening mental health support for adolescents and implementing stricter controls on the accessibility of psychotropic medications and highly toxic pesticides.

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