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

Asmaa F Sharif1,2, Ghada N El-Sarnagawy1, Samar H A Aloshari3

  • 1Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt.

Risk Management and Healthcare Policy
|December 29, 2025
PubMed

Insights

Acute pediatric poisoning is a major health issue. This study identified key risk factors for pediatric intensive care unit (PICU) admission and mortality, particularly from non-pharmaceutical exposures like Aluminum phosphide (AlP).

Area of Science:

  • Pediatric Toxicology
  • Public Health
  • Emergency Medicine

Background:

  • Acute pediatric intoxication presents a significant global health burden.
  • Differentiating pharmaceutical from non-pharmaceutical poisoning is vital for timely diagnosis and effective prevention.
  • Understanding poisoning characteristics across pediatric age groups is crucial for targeted interventions.

Purpose of the Study:

  • To develop risk prediction nomograms for pediatric intensive care unit (PICU) admission and mortality.
  • To identify key predictors of severe outcomes in pediatric poisoning cases.
  • To differentiate between pharmaceutical and non-pharmaceutical poisoning impacts in children.

Main Methods:

  • A three-year retrospective cohort study involving 1328 exposed children.
  • Development of risk prediction nomograms for PICU admission and mortality.
  • Analysis of demographic, exposure, and clinical data to identify significant predictors.

Main Results:

  • Aluminum phosphide (AlP) was a leading cause of mortality and PICU admission.
  • Non-pharmaceutical poisoning was linked to more severe outcomes and exclusively to mortality.
  • Predictive models for mortality (99% accuracy) and PICU admissions (Nagelkerke pseudo-R² of 0.710) were developed.
  • Key predictors for PICU need included rapid admission and leucocytosis; age, sex, and blood pressure were significant factors for both mortality and PICU need.

Conclusions:

  • Findings highlight critical differences in poisoning characteristics and outcomes based on age and exposure type.
  • Preventive strategies, including family education and social awareness, are essential.
  • Psychological support for at-risk individuals is recommended to mitigate poisoning risks.
Abstract

Keywords:
mortality: pediatric intensive care unitnon-pharmaceuticalpediatricpharmaceuticalpoisoning

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