Clinico-epidemiology of drug overdose in a tertiary care hospital

Background: Drug overdose is a common health problem and recently, deliberate self-poisoning using medicinal drugs is becoming popular in both urban and rural areas of Sri Lanka. This study aimed to describe the epidemiology and clinical manifestations following drug overdose in adults.Methods: A prospective clinical study was conducted in Teaching Hospital Ratnapura, Sri Lanka over one year commencing from September ۲۰۱۸ including all adult patients with drug overdose.Results: There were ۲۰۲ (۲۱%) adult patients with drug overdose from which deliberate self-poisonings were ۲۰۰ (۹۹%) and accidental poisonings were ۲ (۱%). Females were ۱۲۴ (۶۱%) and the commonly affected age group was ۱۵-۳۰ years (۱۵۸;۷۸%). The commonest overdosing agent was paracetamol (۱۰۹:۵۴%). Most patients (۹۶;۴۷.۵%) were admitted to the hospital within ۱-۴ hours of the ingestion (IQR ۲-۴ hrs). Most of the patients (۸۶;۴۲.۵%) were treated at hospital for ۲ days (۱QR ۲-۳ days). Decontamination was done for ۱۵۱ (۷۵%) of patients. Gastrointestinal symptoms including nausea and vomiting occurred prominently and they were ۴۲% (n=۸۹) and ۵۳ % (n=۱۱۳) respectively.  Complications were detected in ۱۵ (۷.۴%) cases from which ECG changes ۶ (۳%), respiratory failure ۵ (۲.۵%), acute liver failure ۴ (۲%), acute kidney injury ۳ (۱.۵%) and hypotension ۳ (۱.۵%). Six (۳%) were treated at the intensive care unit from which ۵ (۲.۵%) were intubated. There were ۲ (۱%) deaths and the case fatality rate of drug overdose was ۱%.Conclusions: Drug overdoses are common in intentional type. Young females are mostly affected and the commonest overdosing agent is paracetamol.

کلیدواژه ها:

Paracetamol ، Sri Lanka ، Self-poisoning