Abstract
BackgroundRodenticide poisoning remains a major public health problem in Asian countries. Nevertheless, very few data are available in world literature regarding the outcomes of these patients. Therefore, the purpose of this study was to investigate the clinical outcomes of rodenticide poisonings in our hospital and to compare these data with published reports from other international poison centers.FindingsWe retrospectively examined the records of 20 patients with rodenticide poisoning (8 brodifacoum, 12 bromadiolone) who were referred to Chang Gung Memorial Hospital between 2000 and 2011. It was found that most of the rodenticide patients were middle-aged adults. Both genders were equally affected and many patients had a past history of major depressive disorder or schizophrenia. Nevertheless, patients with bromadiolone were referred significantly sooner than patients with brodifacoum poisoning (0.1 ± 0.1 versus 5.5 ± 10.5, P < 0.001). Furthermore, it was found that patients with brodifacoum suffered higher incidences of ecchymosis (50.0% versus 0%, P = 0.006) and hematuria (50.0% versus 0%, P = 0.006) than patients with bromadiolone poisoning. Laboratory analysis also demonstrated a poorer hemostatic profile of patients with brodifacoum [prothrombin time (PT), international normalized ratio (INR), 4.3 ± 4.8 versus 1.0 ± 0.1, P = 0.032; PT prolongation, 50.0% versus 0%, P = 0.006; activated partial thromboplastin time (aPTT) prolongation, 50.0% versus 0%, P = 0.006] than patients with bromadiolone poisoning. At the end of analysis, no patient died of the poisoning.ConclusionThe favorable outcome (zero mortality rate) is comparable to the published reports from other international poison centers. Further studies are warranted.
Highlights
Superwarfarin rodenticide consists of two classes of compounds, the 4-hydroxycoumarins and the indandiones (Gunja et al 2011)
We retrospectively examined the records of 20 patients with rodenticide poisoning (8 brodifacoum, 12 bromadiolone) who were referred to Chang Gung Memorial Hospital between 2000 and 2011
Laboratory analysis demonstrated a poorer hemostatic profile of patients with brodifacoum [prothrombin time (PT), international normalized ratio (INR), 4.3 ± 4.8 versus 1.0 ± 0.1, P = 0.032; PT prolongation, 50.0% versus 0%, P = 0.006; activated partial thromboplastin time prolongation, 50.0% versus 0%, P = 0.006] than patients with bromadiolone poisoning
Summary
Superwarfarin rodenticide consists of two classes of compounds, the 4-hydroxycoumarins and the indandiones (Gunja et al 2011). Given that the 4-hydroxycoumarin derivatives brodifacoum and bromadiolone are the most frequently used rodenticides in Taiwan, they account for the majority of rodenticide poisonings reported to our poison center Both brodifacoum and bromadiolone act by the same mechanism as warfarin but are 100 times more potent and have much longer serum and tissue half-lives The purpose of this study was to investigate the clinical outcomes of these poisonings in our hospital and to compare these data with published reports from other international poison centers. The purpose of this study was to investigate the clinical outcomes of rodenticide poisonings in our hospital and to compare these data with published reports from other international poison centers
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