Journal de toxicologie clinique
Libre accès

Abstrait

An Epidemiological Study of Adult Acute Poisoning in Fez: Morocco

Boukatta Brahim, El Bouazzaoui Abderrahim, Guemoune Reda, Houari Nawfal, Achour Sanae, Sbai Hicham and Kanjaa Nabil

Introduction: Acute poisoning represents a real health problem in the world. It’s a frequent cause of admission to emergency departments and in the intensive care unit. This study aims to analysis epidemiological aspects, clinics, therapeutic, outcome and the factors of mortality of poisoning in Fez, Morocco. Methods: It’s a retrospective study, concerned all patients admitted for poisoning at the intensive care unit, from January 2009 to December 2012. Results: There were 201 patients admitted for acute poisoning. The median age was 26.26 years with a female predominance (74.1%). The circumstances of poisoning were suicidal, accidental and unknown in 85%, 10% and 5% respectively. Ingestion was the major route of exposure (94.5%), followed by inhalation (5.5%). The most frequent main toxic agents were pesticides (64.17%), medication (22.38%), carbon monoxide (5.5%) and caustic agents (5.5%). The main symptoms were nausea, vomiting and abdominal pain in 117 cases (58.2%). Disorders of consciousness were reported in 62 cases (30.8%). Hemodynamic instability was associated especially with acute aluminum phosphide poisoning. Increase of Troponin Ic was observed in 23 cases (12.7%). The electrocardiogram was abnormal in 21 cases (10.4%) especially with acute aluminum phosphide and carbon monoxide poisonings. Gastric lavage was done for 158 patients (78.60%). 33 patients (16.6%) were need mechanical ventilation. 19 patients (9.5%) of aluminium phosphide poisoning were needed vasoactive. The rate of mortality was 10.9%. The aluminium phosphide poisoning was responsible for 18 (81.8%) deaths. Apart from AIP poisoning, the mortality rate was 2.18%. The statistically significant prognosis factors for death were aluminium phosphide poisoning, cardiovascular signs as shock, myocarditis, electrocardiogram abnormalities, elevated cardiac troponin levels, respiratory distress, need for mechanical ventilation and vasoactive drugs. Conclusion: This epidemiological study revealed the high mortality associated with acute poisonings, especially to aluminium phosphide. The prevention remains the best approach for reducing morbidity and mortality.