섭취를 통한 급성중독으로 단일기관 응급실을방문한 소아환자의 나이대별 특성

Abstract

Purpose: To investigate the age group characteristics of children who visited the emergency department with acute poisoning by ingestion. Methods: We reviewed children under 19 years who visited the emergency department for acute poisoning by ingestion from 2012 to 2017. The children were divided into 3 age groups; infants (0-1 years), preschoolers (2-5 years), and schoolers (6-18 years). Clinical characteristics, intentional ingestion, involved substances (drugs, household products, artificial substances, and pesticides), decontamination and antidote therapy, and outcomes of the 3 age groups were compared. We also performed multivariable logistic regression analysis to identify factors associated with hospitalization. Results: A total of 622 children with acute poisoning by ingestion were analyzed. Their annual proportions to overall pediatric emergency patients ranged from 0.3% to 0.4%. Age distribution showed bimodal peaks at 0-2 years and 15-17 years. The infants showed lower frequency of girls, intentional ingestion, ingestion of drugs, performance of decontamination and antidote therapy, and hospitalization than 2 older groups (P < 0.001). Most decontamination, antidote therapy, and hospitalization occurred in the schoolers (P < 0.001). The most frequently reported substances were household cleaning substances in the infants (18.2%), antihistamines in the preschoolers (15.8%), and analgesics in the schoolers (37.5%). The factors associated with hospitalization were intentional ingestion (adjusted odds ratio [aOR], 7.08; 95% confidence interval [CI], 2.85-17.61; P = 0.001) and schoolers (aOR, 2.33; 95% CI, 1.10-7.53; P = 0.031; compared with infants). Only 1 in-hospital mortality was found in a boy aged 2 years who ingested methomyl. Conclusion: Infants may experience non-intentional ingestion, ingestion of non-pharmacologic substances (especially household cleaning substances), discharge without decontamination and antidote therapy more frequently than older children. Thus, we need age group-specific, preventive and therapeutic plans for children with acute poisoning.