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Evaluating the Characteristics and Outcomes of Acute Pharmaceutical Exposure in Children: 5-Year Retrospective Study
Zhu Yan Duan1, Yan Ning Qu1,2, Rui Tang3
1Emergency Department, Capital Center for Children's Health, Capital Medical University, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China, 86 13020013651.
Insights
Most children exposed to acute pharmaceuticals show no symptoms and require no specific therapy. However, immediate screening and intervention are crucial for those with severe symptoms, intentional poisoning, or exposure to toxic substances.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Toxicology
- Public Health
Background:
- Acute pharmaceutical exposure in children poses significant health risks and strains medical resources.
- Understanding the clinical patterns of pediatric pharmaceutical exposure is vital for effective management.
Purpose of the Study:
- To analyze the clinical characteristics and outcomes of acute pharmaceutical exposures in children.
- To identify risk factors associated with hospitalization for pharmaceutical exposure in pediatric patients.
- To inform preventive strategies and public health initiatives.
Main Methods:
- Retrospective analysis of electronic medical records for children with acute pharmaceutical exposure (2019-2023).
- Data collection included clinical manifestations, laboratory results, interventions, and outcomes.
- Logistic regression analysis was used to determine risk factors for hospitalization.
Main Results:
- Vitamins, NSAIDs, and psychiatric drugs were the most common exposures.
- 74.3% of children showed no symptoms, and 68.1% required no specific therapy.
- Multisystem involvement, psychiatric drug exposure, and intentional poisoning were independent risk factors for hospitalization.
Conclusions:
- While most pediatric pharmaceutical exposures are benign, prompt assessment is critical for severe cases.
- Toxicology screening and intervention are essential for symptomatic children, intentional ingestions, and exposure to highly toxic substances.
- Enhanced public education and safe storage practices are recommended to prevent pediatric pharmaceutical exposures.
Background:
Acute pharmaceutical exposure in children can lead to severe health outcomes and contribute to the inefficient use of medical resources.
Objective:
This study aimed to investigate the clinical characteristics and outcomes of children with acute pharmaceutical exposure to guide the development of preventive strategies and educational initiatives.
Methods:
We analyzed real-world data from electronic medical records of children admitted to the emergency department of a pediatric hospital for acute pharmaceutical exposure between January 2019 and December 2023. Clinical data, including laboratory test results, interventions, and outcomes, were collected. We compared different exposure events and conducted logistic regression analysis to identify risk factors for hospitalization.
Results:
A total of 653 children were included in the study. The most common drugs involved in exposure were vitamins (149/653, 22.8%), nonsteroidal anti-inflammatory drugs (92/653, 14.1%), and psychiatric drugs (74/653, 11.3%). In total, 74.3% (469/631) of patients with complete clinical manifestation data showed no symptoms after exposure, and 68.1% (445/653) of patients did not require specific therapy. Toxicology screening was performed for 11% (72/653) of the children, and 69.4% (50/72) of these tests were positive. Independent risk factors for hospitalization included multisystem involvement (odds ratio [OR] 4.575, 95% CI 1.709-12.251, P=.002), psychiatric drugs (OR 6.280, 95% CI 2.189-18.020, P=.001), and intentional poisoning (OR 12.892, 95% CI 2.222-74.796, P=.004).
Conclusions:
Children with acute pharmaceutical exposure exhibit diverse clinical characteristics and outcomes, with most requiring no specific treatment. However, immediate toxicology screening and clinical intervention are essential for those exhibiting rapidly developing or multisystem symptoms, as well as those with intentional exposure or exposure to known highly toxic substances. Future pediatric health care policies should emphasize safe storage practices and public education on the prevention of pharmaceutical exposure.
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