Clinical and demographic characteristics of pediatric poisoning cases in an emergency department :  Pediatric poisoning cases

Sevilay Kök; Belen Ateş; Alper Kaçar; Hüseyin Dağ; Vefik Arıca

doi:10.5281/zenodo.17871918

Authors

Sevilay Kök University of Health Sciences Prof. Dr. Cemil Taşcıoğlu City Hospital, Department of Pediatric, Istanbul, Turkey https://orcid.org/0000-0001-8732-3758
Belen Ateş University of Health Sciences Prof. Dr. Cemil Taşcıoğlu City Hospital, Department of Pediatric, Istanbul, Turkey https://orcid.org/0000-0002-4525-8764
Alper Kaçar University of Health Sciences Prof. Dr. Cemil Taşcıoğlu City Hospital, Department of Pediatric Emergency, Istanbul, Turkey https://orcid.org/0000-0001-7577-5386
Hüseyin Dağ University of Health Sciences Prof. Dr. Cemil Taşcıoğlu City Hospital, Department of Pediatric, Istanbul, Turkey https://orcid.org/0000-0001-7596-7687
Vefik Arıca University of Health Sciences Prof. Dr. Cemil Taşcıoğlu City Hospital, Department of Pediatric, Istanbul, Turkey https://orcid.org/0000-0002-2080-4677

DOI:

https://doi.org/10.5281/zenodo.17871918

Keywords:

Child, drug, pediatric emergency, poisonings

Abstract

Objective: This study aimed to evaluate the epidemiological and demographic characteristics of childhood poisoning cases.

Methods: Patients admitted to the Pediatric Emergency Department due to drug and non-drug toxin poisoning within a 2-year period were evaluated retrospectively. Substance abusers, chronic medication poisonings, drug reactions, and insect bites were excluded from the study. Patient age, gender, date/time of admission, time of poisoning, causative agents, reason for ingestion, frequency of calls to the poison control center, complaints and findings at admission, interventions and treatments, clinical outcomes, and follow-up duration were recorded and evaluated using hospital records.

Results: The total number of pediatric emergency department visits during the study period was 360,945. Of the cases presented to the pediatric emergency clinic over the 2-year period, 880 (0.24%) were diagnosed with intoxication. The majority of cases were in the 1–5-year age group (57.4%). Of all patients, 55% were girls and 45% were boys. Drugs were the most common cause of poisoning (64.7%, n = 569/880). Among drug-related poisonings, analgesics and antipyretics were the leading agents (9.3% of all cases). Medication poisonings were more common in girls (59.4%), while other poisonings were more common in boys (53.5%). The proportion of suicidal poisoning was significantly higher in girls (33.7%) and occurred predominantly in adolescents (p < 0.001). One-third of female adolescents presented with suicidal poisonings, representing a significant clinical concern. Poisoning from environmental or exposure agents were significantly higher in boys (60.4%) (p < 0.001).

Conclusion: Childhood poisonings represent a preventable cause of morbidity and mortality worldwide. Prevention is achievable only through raising public awareness and implementing appropriate protective measures.

References

1. Northrop AJ, Do V, Flores NM, Wilner LB, Sheffield PE, Casey JA. Power Outages and Carbon Monoxide Poisoning in Children. Pediatrics. 2025;155:e2024068213.

2. Türkmenoğlu Y, Kaçar A, Terlemez B, Güvener G, Bütün P, Yolgiden Guren S, et al. Differences in acute childhood poisoning: A single center experience. TJFMPC. 2021;15:451-60.

3. America’s Poison Centers. 2022 Annual Report of the National Poison Data System (NPDS): 40th Annual Report. Clinical Toxicology. 2023;61:717-939.

4. Aydın K, Erkut Z. Evaluation of characteristics of children admitted to pediatric emergency department with poisoning during the epidemic process: A retrospective study. İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2023;8:421-7.

5. Soave PM, Curatola A, Ferretti S, Raitano V, Conti G, Gatto A, et al. Acute poisoning in children admitted to pediatric emergency department: A five-year retrospective analysis. Acta Biomed. 2022;93:e2022004.

6. Park J, Jeon W, Ko Y, Choi YJ, Yang H, Lee J, et al. Comparison of the clinical characteristics of pediatric poisoning patients who visited emergency departments before and during the COVID-19 pandemic. J Korean Med Sci. 2022;37:e337.

7. Singer CE, Marinescu P, Sălcudean A. Epidemiological and clinical characteristics of pediatric acute drug intoxications: A retrospective analysis. Children (Basel). 2024;12:44.

8. Mintegi S, Azkunaga B, Prego J, Qureshi N, Dalziel SR, Arana-Arri E, et al. International epidemiological differences in acute poisonings in pediatric emergency departments: An analysis of 363,245 cases in 105 hospitals from 20 countries. Pediatr Emerg Care. 2017;33:389-96.

9. Sahin S, Carman KB, Dinleyici EC. Acute poisoning in children: data of a pediatric emergency unit. Iran J Pediatr. 2011;21:479-84.

10. Dündar İ, Akın Y, Yücel M, Yaykıran D. Çocuk acil servisine ilaç entoksikasyonu nedeni ile başvurmuş olan çocuk ve ergen olguların değerlendirilmesi. Çocuk Acil ve Yoğun Bakım Dergisi. 2021;8:110-8.

11. Lin YR, Liu TA, Chang YJ, Huang YC, Chang YJ. Clinical spectrum of acute poisoning in children admitted to the pediatric emergency department. Pediatr Neonatol. 2019;60:59-67.

12. Özkan EA. Evaluation of poisoning cases admitted to the pediatric emergency clinic retrospectively. Exp Clin Med. 2022;39:199-203.

13. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Beuhler MC, Rivers LC, et al. 2018 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 36th Annual Report. Clin Toxicol (Phila). 2019;57:1220-413.

14. Li H, Dodd-Butera T, Beaman ML, Pritty MB, Heitritter TE, Clark RF. Trends in Childhood Poison Exposures and Fatalities: A Retrospective Secondary Data Analysis of the 2009-2019 U.S. National Poison Data System Annual Reports. Pediatr Rep. 2021;13:613-23.

15. Santiago P, Bilbao N, Martinez-Indart L, Mintegi S, Azkunaga B. Epidemiology of acute pediatric poisonings in Spain: a prospective multicenter study from the Spanish Society of Pediatric Emergency Medicine. Eur J Emerg Med 2020;27:284-9.

16. Dağ ÖO, Yeşil Y, Özdemir AA. Acute poisoning in pediatric emergency department: a 5-year analysis. Cerrahpaşa Med J. 2024;48:201-6.

17. Peden M, Oyegbite K, Ozanne-Smith J, Hyder AA, Branche C, Rahman AKMF, et al. World report on child injury prevention. Geneva: World Health Organization; 2008.

18. Dai Q, Wang L, Gao X, Du D, Shuai P, Li L, et al. Clinical and epidemiological characteristics of acute poisoning in children in southwestern China: A review of 1755 cases from 2014 to 2020. Int J Gen Med. 2022;15:133-42.

19. Soave PM, Curatola A, Ferretti S, Raitano V, Conti G, Gatto A, et al. Acute poisoning in children admitted to pediatric emergency department: a five-years retrospective analysis. Acta Biomed. 2022;93:e2022004.

20. Goksu S, Koyuncu M, Turan T, Yildiz A. Characteristics of adolescent patients presenting to the emergency department with drug intoxication. Turk J Emerg Med. 2020;20:1-6.

21. Gunnell D, Appleby L, Arensman E, Hawton K, John A, Kapur N, et al. Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry. 2020;7:468-71.

22. Zhao J, Hu J, Liu Y. Emergency department visits for pediatric poisoning in China: A 318-case review. Med Sci Monit. 2025;31:e946496.

23. Kaba İ, Demirbaş SC, Kendirci HNP. Evaluation of Poisoning Cases Presenting to the Pediatric Emergency Department. Medical Records. 2023:513-7.

24. Biçer S, Sezer S, Çetindağ F, Kesikminare M, Tombulca N, Aydoğan G, et al. Çocuk acil kliniği 2005 yılı akut zehirlenme olgularının değerlendirilmesi. Marmara Med J. 2015;20:12-20.

25. Cho C, Chiu N, Ho C, Peng C. Carbon monoxide poisoning in children. Pediatr Neonatol. 2008;49:121-5.

26. Iloughmane Z, Chemsi M, Kaddouri A, Radi A, Argubi FZ, Sellouti M, et al. Interest of hyperbaric oxygen therapy in childhood carbon monoxide poisoning: A retrospective study. Asian J Pediatr Res. 2020;4:11-6.

27. Güzel Y, Battal F, Aylanç H. Poisoning cases admitted to the pediatric emergency department: A retrospective evaluation. J Pediatr Emerg Intensive Care Med. 2022;9:1-6.

28. Suting E, Bhaskar V, Batra P. Changing epidemiology of poisoning in children: A retrospective study from a tertiary care center in New Delhi, India. Indian J Public Health. 2021;65:400-2.