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Bursa'daki Zehirlenme Vakalarına Genel Bakış

Yıl 2022, Cilt: 4 Sayı: 3, 59 - 64, 31.12.2022
https://doi.org/10.51262/ejtox.1189966

Öz

Amaç: Bu çalışmada amacımız ilimizdeki zehirlenme sebeplerini en sık görülen etkenleri incelemek ülkemizdeki epidemiyolojik çalışmalara katkıda bulunup ülke kaynakların verimli kullanılmasını sağlamaktır.
Gereç ve Yöntem: Çalışmamız 01.02.2020 ile 31.08.2022 tarihleri arasında Bursa ili kamu ve özel hastanelerin acil servislerine zehirlenme nedeniyle başvuran ve Bursa İl Sağlık Müdürlüğü istatistik raporlama birimine bildirimi yapılan tüm hastalar retrospektif olarak tarandı.
Bulgular: Zehirlenme nedenlerinin cinsiyetler arası farklarını değerlendirdiğimizde besin kaynaklı zehirlenmelerin erkeklerde daha sık olduğu (n:322-78), ilaç kaynaklı zehirlenmelerin kadınlarda daha sık olduğu (n:363-556) görülmüştür. Ayrıca yaptığımız Pearson Ki-kare analizinde zehirlenme nedenleri bakımından erkekler ile kadınlar arasında istatistiksel olarak anlamlı fark saptanmıştır (x2=217.06, p<0.01). Zehirlenme nedenlerinin yaş grupları arası farklarını değerlendirdiğimizde en düşük zehirlenme gelişen yaş grubunun %6.3 (n:111) ile <55 kişilerde olduğu görülmüştür. 0-13 yaş grubunda koroziv zehirlenmeleri tüm yaş gruplarının %72.7'sini (n:109) oluşturmaktadır. Methil alkol zehirlenmeleri en sık 36-55 yaş grubunda görülmektedir. Yapılan ki-kare analizinde zehirlenme nedenleri bakımından kategorize edilmiş yaş grupları arasında istatistiksel olarak anlamlı fark saptandı (x2=641.80, p<0.01). Çalışmaya alınan hastaların acil servisten taburculuk ve yatış dağılımlarına baktığımızda eksitus olan hastaların zehirlenme nedenleri; karbon monoksit (n:2), ilaçlar (n:1), etil alkol (n:1), metil alkol (n:1) ve diğer nedenler (n:1) şeklindedir. Ayrıca en sık yoğun bakım yatışı gereken zehirlenme nedeni ilaçlar (n:82) olmuştur. Zehirlenme nedenleri ile hastaların sonlanım durumları bakımından istatiksel anlamlı fark saptanmıştır (x2=238.42, p<0.01). Zehirlenme nedenlerinin mevsimsel farklarına baktığımızda ilaçlar ile olan zehirlenme vakaları her mevsim diğer faktörlerden fazla olarak görülürken, karbonmonoksit zehirlenmesi kış aylarında, gıda zehirlenmesi yaz aylarında, mantarlar ise sonbaharda daha fazla görülmüştür. Zehirlenme nedenleri mevsimler bakımından istatistiksel olarak anlamlı fark göstermektedir.
Sonuç: Zehirlenmede bir bölgedeki yerel nedenlerin analizi çok önemlidir. Bu sayede o bölgeye özel önlemler alınabilir. Bu sayede antitoksin planlaması ve insan gücü planlaması daha etkin hale getirilebilir.

Kaynakça

  • Weltgesundheitsorganisation, W.H. Organization, and E.C.f. Environment, WHO global air quality guidelines: particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. Geneva: World Health Organization 2021 Licence: CC BY-NC-SA 3.0 IGO.
  • Alinejad S, Zamani N, Abdollahi M, Mehrpour O. A Narrative Review of Acute Adult Poisoning in Iran. Iran J Med Sci. 2017;42(4):327-346.
  • Desalew M, Aklilu A, Amanuel A, Addisu M, Ethiopia T. Pattern of acute adult poisoning at Tikur Anbessa specialized teaching hospital, a retrospective study, Ethiopia. Hum Exp Toxicol. 2011;30(7):523-7.
  • Kaale E. A retrospective study of poisoning at Muhimbili National Hospital in Dar-Es Salaam, Tanzania. J Public Health Front, 2013. 2(1): p. 21-26.
  • WHO. Mental health. Available from: https://www.who.int/mental_ health/prevention/suicide/suicideprevent/en/. Accessed September 30, 2022.
  • Hanssens Y, Deleu D, Taqi A. Etiologic and demographic characteristics of poisoning: a prospective hospital-based study in Oman. J Toxicol Clin Toxicol. 2001;39(4):371-80.
  • Viccellio, P., Handbook of medical toxicology. 1st ed. Boston: Little, Brown, and Company,1993.
  • Akkose S, Bulut M, Armagan E, Cebicci H, Fedakar R. Acute poisoning in adults in the years 1996-2001 treated in the Uludag University Hospital, Marmara Region, Turkey. Clin Toxicol (Phila). 2005;43(2):105-9.
  • Mert E, Bilgin NG. Demographical, aetiological and clinical characteristics of poisonings in Mersin, Turkey. Hum Exp Toxicol. 2006;25(4):217-23.
  • Camidge DR, Wood RJ, Bateman DN. The epidemiology of self-poisoning in the UK. Br J Clin Pharmacol. 2003;56(6):613-9. .
  • Thanacoody R., Anderson M. Epidemiology of poisoning. Medicine, 2020. 48(3):153-155.
  • Kalaycı, A., et al., Causes of poisoning in childhood. Journal of New Medicine, 1994. 11(1): p. 4-7.
  • Uzel N. Zehirlenmeledanismar Neyzi O, Ertuğrul T. Pediatri 2002;25:1529-38.
  • Bertolote JM, Fleischmann A, Eddleston M, Gunnell D. Deaths from pesticide poisoning: a global response. Br J Psychiatry. 2006;189:201-3.
  • Carter G, Reith DM, Whyte IM, McPherson M. Repeated self-poisoning: increasing severity of self-harm as a predictor of subsequent suicide. Br J Psychiatry. 2005;186:253-7.
  • Lee HL, Lin HJ, Yeh SY, Chi CH, Guo HR. Etiology and outcome of patients presenting for poisoning to the emergency department in Taiwan: a prospective study. Hum Exp Toxicol. 2008;27(5):373-9.
  • Karakaya A, Vural N. Acute poisoning admissions in one of the hospitals in Ankara. Hum Toxicol. 1985;4(3):323-6.
  • Ozköse Z, Ayoglu F. Etiological and demographical characteristics of acute adult poisoning in Ankara, Turkey. Hum Exp Toxicol. 1999;18(10):614-8.
  • Pinar A, Fowler J, Bond GR. Acute poisoning in Izmir, Turkey--a pilot epidemiologic study. J Toxicol Clin Toxicol. 1993;31(4):593-601.
  • Akköse Aydın Ş, Köksal Ö, Fedakar R, Emircan Ş, Durmuş O. Poisoning Cases in Adults in the Years 1996-2004. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2006; 32(1): 25-27.
  • Jalali A, Savari M, Dehdardargahi S, Azarpanah A. The pattern of poisoning in southwestern region of iran: envenoming as the major cause. Jundishapur J Nat Pharm Prod. 2012;7(3):100-5.
  • Naseri K, Klani Z, Sajadi ZS, Mehrpour O, Sadeghi M.Pattern of Inpatients Acute Poisonings in Birjand City, East of Iran. 2020.
  • Mehrpour, O., Sharifi, M., & Ebrahimi, M. (2015). Pattern of Acute Pediatric Poisonings in Birjand City, East of Iran. International Journal of Medical Toxicology and Forensic Medicine, 5(4):192-200.
  • Pach J, Polewka A, Zieba A, Kroch S, Chrostek Maj J, Mikołaszek-Boba M, et al.Próba kompleksowej oceny predyktorów ryzyka ponowienia samobójstwa u pacjentów po samobójczym zatruciu lekami, hospitalizowanych w Klinice Toksykologii CM UJ w Krakowie. Cześć II. Predyktory kliniczne [A trial for the complex risk assessment of repeated suicide predictors in patients after suicidal poisoning attempts, hospitalized in the Department of Clinical Toxicology CM UJ in Krakow. II. Clinical predictors]. Przegl Lek. 2001;58(4):330-4.
  • Hatzitolios AI, Sion ML, Eleftheriadis NP, Toulis E, Efstratiadis G, Vartzopoulos D, Ziakas AG. Parasuicidal poisoning treated in a Greek medical ward: epidemiology and clinical experience. Hum Exp Toxicol. 2001;20(12):611-7.
  • Aygin D, Açıl H, Investigation of poisoning cases aged 0-18 years admitted to the pediatric emergency unit. S. EEAH Medical Bulletin, 2014. 48(1): p. 27-33.
  • Merigian KS, Woodard M, Hedges JR, Roberts JR, Stuebing R, Rashkin MC. Prospective evaluation of gastric emptying in the self-poisoned patient. Am J Emerg Med. 1990;8(6):479-83.
  • Sümer V, Güler E, Karanfil R, et al. Evaluation of the poisoning cases who applied to the pediatrics emergency unit. Turk Arch Ped 2011; 46(3): 234-40.
  • Goksu S, Yildirim C, Kocoglu H, Tutak A, Oner U. Characteristics of acute adult poisoning in Gaziantep, Turkey. J Toxicol Clin Toxicol. 2002;40(7):833-7.
  • Watson WA, Litovitz TL, Rodgers GC Jr, Klein-Schwartz W, Youniss J, Rose SR, et al.2002 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2003;21(5):353-421.
  • Froede SM, Byers JM 3rd, Wolfgang GH, Froede RC, Jones AM, Henry TE. An analysis of toxic deaths, 1982 to 1985, Pima County, Arizona. J Forensic Sci. 1987;32(6):1676-93
  • TÜRKMEN İNANIR N,AKGÖZ S Bursa'da otopsisi yapılan karbonmonoksit zehirlenmesine bağlı ölümler. Adli Tıp Dergisi. 2005; 19(2): 20 - 25.
  • Duman E, Akgün SA, Öztürk P, Ertürk S, Şen F, Ege B. Evaluation of poisoning cases in autopsies performed in İzmir between 1997-2000. Annual Forensic Medicine Meetings 2001 Book (25-27 April 2001, İstanbul) 313-7 .
  • Ok G. Our one-year poisoning cases. First Interdisciplinary Toxicology Congress Proceedings Abstract Book. 2005; 211.
  • Shin SD, Suh GJ, Rhee JE, Sung J, Kim J. Epidemiologic characteristics of death by poisoning in 1991-2001 in Korea. J Korean Med Sci. 2004;19(2):186-94.
  • Lamireau T, Llanas B, Kennedy A, Fayon M, Penouil F, Favarell-Garrigues JC, Demarquez JL. Epidemiology of poisoning in children: a 7-year survey in a paediatric emergency care unit. Eur J Emerg Med. 2002;9(1):9-14.
  • Dragisic T, Dickov A, Dickov V, Mijatovic V. Drug Addiction as Risk for Suicide Attempts. Mater Sociomed. 2015;27(3):188-91.

Overview of Poisoning Cases in Bursa

Yıl 2022, Cilt: 4 Sayı: 3, 59 - 64, 31.12.2022
https://doi.org/10.51262/ejtox.1189966

Öz

Aim: In this study, our aim is to examine the most common causes of poisoning in our city, to contribute to the epidemiological studies in our country and to ensure the efficient use of the country's resources.
Material and methods: In our study, all patients who admitted to the emergency departments of public and private hospitals in Bursa between 01.02.2020 and 31.08.2022 due to poisoning and were reported to the statistical reporting unit of Bursa Provincial Health Directorate were retrospectively evaluated.
Results: The gender differences in the causes of poisoning was seen that food-related poisoning was more common in men (n:322-78), and drug-induced poisoning was more common in women (n:363-556) and the difference was found to be statistically significant (x2=217.06, p<0.01). When we evaluated the differences in the causes of poisoning between age groups, it was seen that the lowest intoxication age group was <55 years of age (6.3%, n:111). Corrosive poisonings in the 0-13 age group constitute 72.7% (n:109) of all age groups. Methyl alcohol poisonings are most common in the 36-55 age group. In the chi-square analysis, a statistically significant difference was found between the age groups categorized in terms of the causes of poisoning (x2=641.80, p<0.01). When we look at the outcomes of the patients included in the study, the causes of poisoning in the patients who died were carbon monoxide poisoning (CO) (n:2), drugs (n:1), ethyl alcohol (n:1), were respectively. In addition, the most common cause of poisoning requiring ICU admission was drugs (n:82). When we look at the seasonal differences in the causes of poisoning, poisoning cases with drugs are seen more than other factors in every season, while CO is seen more in winter, food releated in summer and musrooms in autumn. The causes of poisoning show a statistically significant difference in terms of seasons (x2=565.35, p<0.01).
Conclusions: Analysis of local causes in a region is very important in poisoning. In this way, measures specific to that region can be taken. In this way, antitoxin planning and manpower planning can be made more effective.

Kaynakça

  • Weltgesundheitsorganisation, W.H. Organization, and E.C.f. Environment, WHO global air quality guidelines: particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. Geneva: World Health Organization 2021 Licence: CC BY-NC-SA 3.0 IGO.
  • Alinejad S, Zamani N, Abdollahi M, Mehrpour O. A Narrative Review of Acute Adult Poisoning in Iran. Iran J Med Sci. 2017;42(4):327-346.
  • Desalew M, Aklilu A, Amanuel A, Addisu M, Ethiopia T. Pattern of acute adult poisoning at Tikur Anbessa specialized teaching hospital, a retrospective study, Ethiopia. Hum Exp Toxicol. 2011;30(7):523-7.
  • Kaale E. A retrospective study of poisoning at Muhimbili National Hospital in Dar-Es Salaam, Tanzania. J Public Health Front, 2013. 2(1): p. 21-26.
  • WHO. Mental health. Available from: https://www.who.int/mental_ health/prevention/suicide/suicideprevent/en/. Accessed September 30, 2022.
  • Hanssens Y, Deleu D, Taqi A. Etiologic and demographic characteristics of poisoning: a prospective hospital-based study in Oman. J Toxicol Clin Toxicol. 2001;39(4):371-80.
  • Viccellio, P., Handbook of medical toxicology. 1st ed. Boston: Little, Brown, and Company,1993.
  • Akkose S, Bulut M, Armagan E, Cebicci H, Fedakar R. Acute poisoning in adults in the years 1996-2001 treated in the Uludag University Hospital, Marmara Region, Turkey. Clin Toxicol (Phila). 2005;43(2):105-9.
  • Mert E, Bilgin NG. Demographical, aetiological and clinical characteristics of poisonings in Mersin, Turkey. Hum Exp Toxicol. 2006;25(4):217-23.
  • Camidge DR, Wood RJ, Bateman DN. The epidemiology of self-poisoning in the UK. Br J Clin Pharmacol. 2003;56(6):613-9. .
  • Thanacoody R., Anderson M. Epidemiology of poisoning. Medicine, 2020. 48(3):153-155.
  • Kalaycı, A., et al., Causes of poisoning in childhood. Journal of New Medicine, 1994. 11(1): p. 4-7.
  • Uzel N. Zehirlenmeledanismar Neyzi O, Ertuğrul T. Pediatri 2002;25:1529-38.
  • Bertolote JM, Fleischmann A, Eddleston M, Gunnell D. Deaths from pesticide poisoning: a global response. Br J Psychiatry. 2006;189:201-3.
  • Carter G, Reith DM, Whyte IM, McPherson M. Repeated self-poisoning: increasing severity of self-harm as a predictor of subsequent suicide. Br J Psychiatry. 2005;186:253-7.
  • Lee HL, Lin HJ, Yeh SY, Chi CH, Guo HR. Etiology and outcome of patients presenting for poisoning to the emergency department in Taiwan: a prospective study. Hum Exp Toxicol. 2008;27(5):373-9.
  • Karakaya A, Vural N. Acute poisoning admissions in one of the hospitals in Ankara. Hum Toxicol. 1985;4(3):323-6.
  • Ozköse Z, Ayoglu F. Etiological and demographical characteristics of acute adult poisoning in Ankara, Turkey. Hum Exp Toxicol. 1999;18(10):614-8.
  • Pinar A, Fowler J, Bond GR. Acute poisoning in Izmir, Turkey--a pilot epidemiologic study. J Toxicol Clin Toxicol. 1993;31(4):593-601.
  • Akköse Aydın Ş, Köksal Ö, Fedakar R, Emircan Ş, Durmuş O. Poisoning Cases in Adults in the Years 1996-2004. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2006; 32(1): 25-27.
  • Jalali A, Savari M, Dehdardargahi S, Azarpanah A. The pattern of poisoning in southwestern region of iran: envenoming as the major cause. Jundishapur J Nat Pharm Prod. 2012;7(3):100-5.
  • Naseri K, Klani Z, Sajadi ZS, Mehrpour O, Sadeghi M.Pattern of Inpatients Acute Poisonings in Birjand City, East of Iran. 2020.
  • Mehrpour, O., Sharifi, M., & Ebrahimi, M. (2015). Pattern of Acute Pediatric Poisonings in Birjand City, East of Iran. International Journal of Medical Toxicology and Forensic Medicine, 5(4):192-200.
  • Pach J, Polewka A, Zieba A, Kroch S, Chrostek Maj J, Mikołaszek-Boba M, et al.Próba kompleksowej oceny predyktorów ryzyka ponowienia samobójstwa u pacjentów po samobójczym zatruciu lekami, hospitalizowanych w Klinice Toksykologii CM UJ w Krakowie. Cześć II. Predyktory kliniczne [A trial for the complex risk assessment of repeated suicide predictors in patients after suicidal poisoning attempts, hospitalized in the Department of Clinical Toxicology CM UJ in Krakow. II. Clinical predictors]. Przegl Lek. 2001;58(4):330-4.
  • Hatzitolios AI, Sion ML, Eleftheriadis NP, Toulis E, Efstratiadis G, Vartzopoulos D, Ziakas AG. Parasuicidal poisoning treated in a Greek medical ward: epidemiology and clinical experience. Hum Exp Toxicol. 2001;20(12):611-7.
  • Aygin D, Açıl H, Investigation of poisoning cases aged 0-18 years admitted to the pediatric emergency unit. S. EEAH Medical Bulletin, 2014. 48(1): p. 27-33.
  • Merigian KS, Woodard M, Hedges JR, Roberts JR, Stuebing R, Rashkin MC. Prospective evaluation of gastric emptying in the self-poisoned patient. Am J Emerg Med. 1990;8(6):479-83.
  • Sümer V, Güler E, Karanfil R, et al. Evaluation of the poisoning cases who applied to the pediatrics emergency unit. Turk Arch Ped 2011; 46(3): 234-40.
  • Goksu S, Yildirim C, Kocoglu H, Tutak A, Oner U. Characteristics of acute adult poisoning in Gaziantep, Turkey. J Toxicol Clin Toxicol. 2002;40(7):833-7.
  • Watson WA, Litovitz TL, Rodgers GC Jr, Klein-Schwartz W, Youniss J, Rose SR, et al.2002 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2003;21(5):353-421.
  • Froede SM, Byers JM 3rd, Wolfgang GH, Froede RC, Jones AM, Henry TE. An analysis of toxic deaths, 1982 to 1985, Pima County, Arizona. J Forensic Sci. 1987;32(6):1676-93
  • TÜRKMEN İNANIR N,AKGÖZ S Bursa'da otopsisi yapılan karbonmonoksit zehirlenmesine bağlı ölümler. Adli Tıp Dergisi. 2005; 19(2): 20 - 25.
  • Duman E, Akgün SA, Öztürk P, Ertürk S, Şen F, Ege B. Evaluation of poisoning cases in autopsies performed in İzmir between 1997-2000. Annual Forensic Medicine Meetings 2001 Book (25-27 April 2001, İstanbul) 313-7 .
  • Ok G. Our one-year poisoning cases. First Interdisciplinary Toxicology Congress Proceedings Abstract Book. 2005; 211.
  • Shin SD, Suh GJ, Rhee JE, Sung J, Kim J. Epidemiologic characteristics of death by poisoning in 1991-2001 in Korea. J Korean Med Sci. 2004;19(2):186-94.
  • Lamireau T, Llanas B, Kennedy A, Fayon M, Penouil F, Favarell-Garrigues JC, Demarquez JL. Epidemiology of poisoning in children: a 7-year survey in a paediatric emergency care unit. Eur J Emerg Med. 2002;9(1):9-14.
  • Dragisic T, Dickov A, Dickov V, Mijatovic V. Drug Addiction as Risk for Suicide Attempts. Mater Sociomed. 2015;27(3):188-91.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Acil Tıp
Bölüm Original Articles
Yazarlar

Salih Metin 0000-0003-1582-7900

Hüseyin Aygün 0000-0002-8933-313X

Yayımlanma Tarihi 31 Aralık 2022
Gönderilme Tarihi 16 Ekim 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 4 Sayı: 3

Kaynak Göster

APA Metin, S., & Aygün, H. (2022). Overview of Poisoning Cases in Bursa. Eurasian Journal of Toxicology, 4(3), 59-64. https://doi.org/10.51262/ejtox.1189966
AMA Metin S, Aygün H. Overview of Poisoning Cases in Bursa. Eurasian J Tox. Aralık 2022;4(3):59-64. doi:10.51262/ejtox.1189966
Chicago Metin, Salih, ve Hüseyin Aygün. “Overview of Poisoning Cases in Bursa”. Eurasian Journal of Toxicology 4, sy. 3 (Aralık 2022): 59-64. https://doi.org/10.51262/ejtox.1189966.
EndNote Metin S, Aygün H (01 Aralık 2022) Overview of Poisoning Cases in Bursa. Eurasian Journal of Toxicology 4 3 59–64.
IEEE S. Metin ve H. Aygün, “Overview of Poisoning Cases in Bursa”, Eurasian J Tox, c. 4, sy. 3, ss. 59–64, 2022, doi: 10.51262/ejtox.1189966.
ISNAD Metin, Salih - Aygün, Hüseyin. “Overview of Poisoning Cases in Bursa”. Eurasian Journal of Toxicology 4/3 (Aralık 2022), 59-64. https://doi.org/10.51262/ejtox.1189966.
JAMA Metin S, Aygün H. Overview of Poisoning Cases in Bursa. Eurasian J Tox. 2022;4:59–64.
MLA Metin, Salih ve Hüseyin Aygün. “Overview of Poisoning Cases in Bursa”. Eurasian Journal of Toxicology, c. 4, sy. 3, 2022, ss. 59-64, doi:10.51262/ejtox.1189966.
Vancouver Metin S, Aygün H. Overview of Poisoning Cases in Bursa. Eurasian J Tox. 2022;4(3):59-64.

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