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Hospitalised poisonings in Australian children: a 10-year retrospective study
Abrar Arbaeen1, Firouzeh Noghrehchi2, Nial J Wheate1
1School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Insights
Approximately 10 Australian children daily require hospitalisation for poisoning, with pharmaceuticals like analgesics being the most common cause. While severe outcomes are rare, understanding risk factors is key to prevention.
Area of Science:
- Public Health
- Paediatric Medicine
- Toxicology
Background:
- Paediatric poisoning is a significant, preventable cause of childhood injury.
- Understanding hospitalisation trends and risk factors is crucial for targeted prevention strategies.
Purpose of the Study:
- To describe hospitalisations for poisoning and envenomation in Australian children.
- To identify demographics, causes, and outcomes including length of stay, ICU admission, and mortality.
- To determine risk factors associated with increased length of stay and ICU admission.
Main Methods:
- Retrospective analysis of Australian hospital admissions data.
- Study period: 1 July 2009 to 30 June 2019.
- Inclusion criteria: Children (<15 years) hospitalised for poisoning or envenomation.
Main Results:
- Over 33,000 hospitalisations occurred, averaging 74.8 per 100,000 children annually.
- Pharmaceuticals accounted for over 70% of cases, with analgesics being most frequent.
- Intentional self-harm was reported in 23.4% of cases; severe outcomes like ICU admission (2.5%) and death (0.03%) were rare.
Conclusions:
- Daily hospital admissions for paediatric poisoning in Australia highlight a substantial public health issue.
- Pharmaceuticals, especially common analgesics, are the leading cause of poisoning, emphasizing the need for household safety.
- While severe outcomes are infrequent, older age and pharmaceutical ingestions are linked to longer hospital stays and ICU admissions.
Introduction:
Paediatric poisoning is a major cause of childhood injury, and most poisonings are preventable. We aimed to describe hospitalisations resulting from poisoning and envenomation in Australian children, including demographics, cause of the exposure, hospital length of stay, rates of intensive care unit admission and in-hospital deaths. We also aimed to describe risk factors for increased length of stay and intensive care unit admission.
Methods:
A retrospective analysis was performed of hospitalised poisoning and envenomation cases of children (<15 years) in Australia from 1 July 2009 to 30 June 2019. A nationwide hospital admissions database was used for this study.
Results:
During the 10-year study period 33,438 children were admitted to hospital due to a pharmaceutical or non-pharmaceutical poisoning/envenomation; an average of 74.8 cases per 100,000 population per year. Approximately 10 children were admitted to hospital each day for poisoning. Over 70% of these cases were due to pharmaceuticals (n = 23,628), most frequently non-opioid analgesics, anti-pyretics and anti-rheumatics (n = 8759, 37.1% of pharmaceutical exposures). The most common non-pharmaceutical exposure was contact with venomous animals and toxic plants (n = 4578, 46.7% of non-pharmaceuticals). Intentional self-harm occurred in 7833 (23.4%) of cases. Intensive care unit admission was required in 519 cases (2.5% of the 20,739 cases where this information was available), while 200 (0.96% of 20,739) needed ventilator support. Ten children (0.03%) died. Older age, female sex, poisoning with pharmaceuticals and metropolitan hospital location were associated with increased length of stay. Older age and poisoning with pharmaceuticals were also associated with intensive care unit admission.
Conclusion:
Approximately 10 children were admitted to hospital with poisoning every day in Australia. Most poisonings were due to pharmaceuticals, particularly simple analgesics that are found in most Australian homes. Severe outcomes (intensive care unit admissions and deaths) were rare.
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