RETROSPECTIVE STUDY OF ACUTE POISONING IN ELDERLY CASES ADMITTED TO MENOUFIA POISONING CONTROL CENTER (MPCC), MENOUFIA UNIVERSITY HOSPITALS FROM 2012 TO 2014

Abstract

Introduction: Elderly people are exposed to poisons more than younger patients and they metabolize many drugs differently. Aim of the study: to evaluate poisoning in elderly patients. Subjects and Methods: A retrospective study was done on 255 elderly poisoned cases (≥ 60 years old) admitted to MPCC within the period from January 2012 to December 2014.The cases were evaluated and they were further statistically analyzed. Results: Out of 6556 acutely poisoned cases throughout the period of study, 3.9% elderly cases were included. 83.5% of cases were in the age group 60-<65 years. Males outnumbered females (62.4%). More than half of the cases (57.6%) were from urban areas. Housewives were the commonest (32.9%) followed by farmers (28.2%). Suicidal attempts were more in retired and free laborers groups 60% and 100% respectively, accidental exposures were 79.2% in farmers while 6.7% of manual workers and 4.2% of farmers were exposed to homicide. Organophosphate was the commonest poisoning substance among farmers (87.5%), while retired, drivers and unemployed were commonly intoxicated by drugs (40%, 40% and 50%respectively). Cases with metabolic acidosis were intoxicated by corrosives & organophosphate 33.3% for each one. Low cholinesterase level was found in 39 cases of organophosphate poisoning. Methanol level was elevated in three cases of alcohol poisoning and Toxi-lab was positive in three cases of drug poisoning. ECG was done for 25 cases, 24% of them showed bradycardia and 16% showed tachycardia. Thirty six cases underwent X-ray, 11.2% & 8.3% showed increased broncho-vascular marking and alveolar opacities respectively. Mortality rate constituted 9.4% of cases. Logistic regression analysis cleared that PH was the most predictor affecting the outcome followed by hypoxia. Conclusion and recommendation: PH, hypoxia and coma were the risk factors in the outcome. Proper evaluation and continuous monitoring of elderly poisoned cases are required to decrease the mortality rates among these patients.