Clinico-epidemiology of drug overdose in a tertiary care hospital

Abstract

Background: Drug overdose is a common health problem and recently, deliberate self-poisoning using medicinal drugs is becoming popular in both urban and rural areas of Sri Lanka. This study aimed to describe the epidemiology and clinical manifestations following drug overdose in adults.Methods: A prospective clinical study was conducted in Teaching Hospital Ratnapura, Sri Lanka over one year commencing from September 2018 including all adult patients with drug overdose.Results: There were 202 (21%) adult patients with drug overdose from which deliberate self-poisonings were 200 (99%) and accidental poisonings were 2 (1%). Females were 124 (61%) and the commonly affected age group was 15-30 years (158;78%). The commonest overdosing agent was paracetamol (109:54%). Most patients (96;47.5%) were admitted to the hospital within 1-4 hours of the ingestion (IQR 2-4 hrs). Most of the patients (86;42.5%) were treated at hospital for 2 days (1QR 2-3 days). Decontamination was done for 151 (75%) of patients. Gastrointestinal symptoms including nausea and vomiting occurred prominently and they were 42% (n=89) and 53 % (n=113) respectively. Complications were detected in 15 (7.4%) cases from which ECG changes 6 (3%), respiratory failure 5 (2.5%), acute liver failure 4 (2%), acute kidney injury 3 (1.5%) and hypotension 3 (1.5%). Six (3%) were treated at the intensive care unit from which 5 (2.5%) were intubated. There were 2 (1%) deaths and the case fatality rate of drug overdose was 1%.Conclusions: Drug overdoses are common in intentional type. Young females are mostly affected and the commonest overdosing agent is paracetamol.

Keywords

• paracetamol
• sri lanka
• self-poisoning