Two-Month Study on Acute Poisoning Cases in a Tertiary Care Hospital in Bangladesh

Introduction

This study presents an observational analysis of acute poisoning cases admitted to Dhaka Medical College Hospital, Bangladesh, over a two-month period, highlighting key demographic, etiological, clinical, and outcome-based trends.

Results

A total of 611 cases were reviewed, with a predominant incidence among young adults aged 20-40 years. The highest fatality rate occurred in the 16-25-year-old cohort, with a secondary fatality peak noted among individuals aged 66-70, indicating varying vulnerability across age groups. Pesticide-related poisonings were common, with nearly equal distributions between organophosphorus compounds (51%) and non-organophosphorus compounds (49%). Commuter poisoning (31.2%) was notably the leading type of non-pesticide poisoning, primarily associated with criminal activities. Suicidal poisoning accounted for most cases at 57.4%, often linked to family disharmony as a frequent underlying factor. Additionally, snake bites (7.5%) emerged as a notable public health concern, especially in rural areas.

Fatalities were highest among those who ingested kerosene (20%), despite its low incidence. Logistic regression analysis identified key predictors of mortality, including severely low Glasgow Coma Scale scores (GCS<9; OR=80.59, p<0.001), hypotension, tachycardia, and pupillary abnormalities. Non-organophosphorus poisonings displayed increased severity in terms of neurological impairment and hypotension compared to organophosphorus poisonings, which mainly resulted in pupillary constriction.

Demographic analysis revealed a higher mortality risk among females, rural residents, and individuals with lower educational attainment, although the statistical significance was limited.

Conclusion

This study identifies important gaps in managing and preventing acute poisoning in Bangladesh. It calls for structured clinical protocols, better training for healthcare providers, and targeted community interventions. Improving public awareness and timely medical responses is essential to reduce poisoning-related morbidity and mortality.