Principal characteristics of patients acutely poisoned by ethanol in the region of Belgrade (Serbia)
Abstract
Background/Aim. Acute intoxication by ethanol constitutes a significant part of the acute pathology caused by toxic chemicals, which require medical care in specialized health care institutions. The aim of the study was to determine some principal characteristics of the patients treated after acute ethanol poisoning, such as: participation in the total number of patients treated after acute poisoning by all chemical agents, age, sex, severity of poisoning and capacities for ambulatory or hospital treatment. Methods. A five-year retrospective case study was conducted on 20,891 acute poisoned patients, of which 10,731 were treated after acute ethanol poisoning during the period 2011–2015. All the subjects satisfied the diagnostic criteria of poisoning according to the World Health Organization International Classification of Diseases-10 and standardized Poison Severity Score scale. Results. Monitored parameters were analyzed in 10,731 patients acutely poisoned by ethanol, and their average number during one study year was 2146.2 ± 437.95. The average number of treated patients due to poisoning by ethanol (51.47 ± 2.86%) was statistically significantly higher than that of other causes of acute poisoning (p < 0.001). The majority of poisoned patients were men, aged 19 to 65 years, with mild to moderate symptoms of acute ethanol intoxication. The highest number of patients poisoned by ethanol had Poison Severity Score 1 (70.25 ± 5.04%, p < 0.001). Very few acute poisoned with ethanol required hospital treatment (1.05%). Anticipated number of patients acutely poisoned by ethanol had high percentage of increase for the period 2016–2020 (slightly more than 20%), which is worrying, primarily due to their high absolute number. Conclusion. Acute alcohol poisoning represents a significant part of the pathology in the total number of patients treated due to acute poisoning with various chemical substances. The results of this analysis showed that certain populations are particularly vulnerable to abuse of alcohol to the level requiring health care (male population, age 19˗65 years). Only a small number of patients (1% of all patients treated for acute alcohol poisoning) required clinical treatment. The obtained data provided the basis for a more targeted preventive action in certain population groups, as well as the adequate planning of professional medical staff engagement, material, spatial and other capacities. These data, also, provided the basis for additional detailed social, economic, health and other researches in this area as well as a more detailed registration of this type of poisoning and establishing a monitoring system and database.
References
Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL. Global Burden of Disease and Risk Factors. 2nd ed. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; New York: Oxford University Press; 2006.
World Health Organization. The world health report 2003 - shaping the future. Geneva: WHO; 2003.
Windfuhr K, While D, Hunt IM, Shaw J, Applebly L, Kapur N. Suicide and accidental deaths in children and adolescents in England and Wales, 2001-2010. Arch Dis Child 2013; 98(12): 945‒50.
Goktas S, Yildirim G, Kose S, Yildrim S, Ozhan F, Senturan L. First aid knowledge of university students in poisoning cases. Turk J Emerg Med 2014; 14(4): 153‒9.
Bergen H, Hawton K, Waters K, Cooper J, Kapur N. Epidemiology and trends in nonfatal self-harm in three centres in England: 2000-2007. Br J Psychiatry 2010; 197(6): 493‒8.
Karasouli E, Owens D, Abbott RL, Hurst KM, Dennis M. All-cause mortality after nonfatal self-poisoning: a cohort study. Soc Psychiatry Psychiatr Epidemiol 2011; 46(6): 455‒62.
Pfab R, Eyer F, Jetzinger E, Hurst KM, Dennis M. Cause and motivation in cases of non-fatal drug overdoses in opiate addicts. Clinic Toxicol 2006; 44(3): 255‒9.
Battal D, Aktas A, Sungur MA, Bilgin NG, Cekin N. Evaluation of poisoning deaths in Cukurova region, Turkey, 2007-2011. Toxicol Ind Health 2016; 32(3): 476‒84.
Owens D, Wood C, Greenwood DC, Hughes T, Dennis M. Mortality and suicide after non-fatal self-poisoning: 16-year outcome study. Br J Psychiatry 2005; 187(5): 470‒5.
Matović V, Buha A. Acute poisoning by drugs. Arh Farm 2012; 62: 83‒91. (Serbian)
Pletcher MJ, Maselli J, Gonzales R. Uncomplicated alcohol intoxication in the emergency department: an analysis of the National Hospital Ambulatory Medical Care Survey. Am J Med 2004; 117(11): 863‒7.
Anđelić S, Petrović S, Lazić BR, Kosjerina M, Stefanović I. Drugs poisoning in Belgrade according to database of Institute for emergency medical services. Sci J Urgent Med - Halo 2009; 15(33): 7‒14. (Serbian)
Rančić N, Ignjatović Ristić D, Radovanović S, Kocic S, Radevic S. Sociodemographic and clinical characteristics of hospitalized patients after suicide attempt: a twenty-year retrospective study. Med Glas (Zenica) 2012; 9(2): 350‒5.
Ignjatović I. Frequency and ethiology of acute poisoning at Hospital Emergency Service Leskovac. Apoll Medic Aescu 2009; 7(1‒2): 33‒44.
Režić T. Yearbook of the Poison Control Center. Belgrade: Military Medical Academy; 2016. (Serbian)
Zhang J, Xiang P, Zhuo X, Shen M. Acute poisoning types and prevalence in shanghai, China, from January 2010 to August 2011. J Foren Sci 2014; 59(2): 441‒6.
Anonymous. Alcohol Use Disorder: A Comparison Between DSM-IV and DSM-5 (New York: NIAAA). Available from: http://pubs.niaaa.nih.gov/publications/dsmfactsheet/dsmfact.pdf. 2016.
Kanny D, Brewer RD, Mesnick JB, Paulozzi LJ, Naimi TS, Lu H. Vital signs: alcohol poisoning deaths - United States, 2010-2012. MMWR Morb Mortal Wkly Rep 2015; 63(53): 1238‒42.
World Health Organization. Global status report on alcohol and health. Geneva: World Health Organization; 2014; 14: 8‒51.
United Nations. World Population Ageing 2015. New York: UN, Department of Economic and Social Affairs, Population Division; 2015. Available from: http://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Report.pdf. 2015.
World Health Organisation. ICD-10 Version 2016. New York: ISCDRHP; 2016. Available from: http://apps.who.int/classifications/icd10/browse/ 2010/en20. 2016.
Persson HE, Sjöberg GK, Haines JA, Pronczuk de Garbino J. Poisoning severity score. Grading of acute poisoning. J Toxicol Clin Toxicol 1998; 36(3): 205‒13.
World Health Organization. Poison Severity Score. Geneva: WHO. Available from: http://www.who.int/ipcs/poisons/pss.pdf. 1998.
Golo DLN, Ćirić-Janković S, Šantrić-Milićević M, Simić S. Alcohol Use among Adolescents in Serbia. Srp Arh Celok Lek 2013; 41(3‒4): 207‒13. (Serbian)
Jakovljević B, Stojanov V, Paunović K, Belojević G, Milić N. Alcohol Consumption and Mortality in Serbia. Croat Med J 2004; 45(6): 764‒8.
Radović Lj, Ćirić-Janković S, Kisin Dj, Kilibarda B. Alcohol Consumption. In: Knežević T, editor. European Survey on Use of Alcohol and Other Drugs Among Young People in Serbia. Belgrade: Donat Graf; 2009. p. 28‒38.
Yaogo A, Fombonne E, Lert F, Melchior M. Adolescent Repeated Alcohol Intoxication as a Predictor of Young Adulthood Alcohol Abuse: The Role of Socioeconomic Context. Subst Use Misuse 2015; 2: 1-10.
Rehm J, Eschmann S. Global monitoring of average volume of alcohol consumption. Soz Praventivmed 2002; 47(1): 48‒58.
Meropol SB, Moscati RM, Lillis KA, Ballow S, Janicke DM. Alcohol-related injuries among adolescents in the emergency department. Ann Emerg Med 1995; 26(2): 180‒6.
Vallersnes OM, Jacobsen D, Ekeberg Ø, Brreke M. Outpatient treatment of acute poisoning by substances of abuse: a prospective observational cohort study. Scand J Traum Resus Emerg Med 2016; 24: 76.