Journal of Krishna Institute of Medical Sciences University (Oct 2023)
Clinicoepidemiological profile and outcome of patients with rat killer poisoning
Abstract
Background: Rodenticide poisoning is an important health problem with a high case fatality rate especially with metal phosphides. Aim and Objectives: To study and analyze the clinicoepidemiological features and outcomes of patients who have consumed different types of rat killer poison at a tertiary healthcare center located in Coimbatore, India. Material and Methods: The present retrospective observational study was conducted at a tertiary care hospital located in Coimbatore between January 2013 through December 2022. Patients above 16 years of age admitted with a diagnosis of rat killer poisoning were included in the study. Patients whose data was not available were excluded from the study. A sample size of 70 participants was considered and the study was conducted by assessing data retrieved from the medical records of the selected patients. Results: In the present study, the mean age of the participants was 27.13 ± 9.74 years, included an equal number of males and females, and 97.1% of participants had ingested the rodenticide deliberately with yellow phosphorus (50%) being the most ingested rodenticide. Most participants were discharged (68.6%), (8.6%) of the participants were deceased and (22.9%) had discharge against medical advice. Liver function tests showed that the mean direct bilirubin value, mean indirect bilirubin, mean Serum Glutamic Oxaloacetic Transaminase (SGOT) level, mean Serum Glutamic Pyruvic Transaminase (SGPT) level and International Normalized Ratio (INR) were all above the normal range. Regarding clinical manifestations, most participants suffered from vomiting (65.7%). The impact of medical interventions on clinical outcomes showed that gastric lavage (given within 2 hours) (p=0.008) and plasma therapy (p=0.001) significantly impacted the clinical outcome of the poisoning. Conclusion: The different clinical profiles assessed showed that rat killer poisoning can result in gastrointestinal symptoms and derangement in liver function tests. Plasma exchange therapy and gastric lavage were found to be effective treatment modalities in patient management.
