Clinico-Epidemiological Prediction of Adverse Outcomes in Acute Pediatric Poisoning: A Risk Prediction Nomogram...

Globally, acute pediatric intoxication is a serious health concern with a significant burden. Differentiation between pharmaceutical and non-pharmaceutical poisoning is crucial for promoting early diagnosis and implementing effective preventive strategies.

This three-year retrospective cohort study investigated 1328 exposed children, aiming to develop risk prediction nomograms to identify patients in need of pediatric intensive care unit (PICU) admission and those at risk of mortality.

With a mean age of 8.21±6.64 years, a mortality rate of 1.7% and a PICU admission rate of 1.3%, more than 99% of infants and preschool children were exposed unintentionally, and intentional exposure was observed in about 88% of adolescents (p<0.001). Aluminum phosphide (AlP) was a leading cause of mortality and PICU admission. Non-pharmaceutical poisoning was associated with more severe clinical presentations and was exclusively linked to mortality. A predictive model for mortality with an overall accuracy of 99% underscores the role of receiving prehospital treatment in increasing the likelihood of mortality. Exposure to AlP contributed to PICU admission with a notably high odds ratio (50.596). Significant predictors of PICU need were rapid admission and leucocytosis. A model predicting PICU admissions, with a Nagelkerke pseudo-R² of 0.710, encompassed mutual factors contributing to mortality and PICU need, including age, sex, and blood pressure.

The obtained findings highlight critical differences in poisoning characteristics and outcomes across pediatric age groups and exposure types, emphasizing a need to implement preventive strategies through proper family education, increased social awareness, and the provision of psychological support for at-risk individuals.