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Clinical and Epidemiological Characteristics of Severe Acute Adult Poisoning Cases in Martinique: Implicated Toxic Exposures and Their Outcomes

1
Intensive Care Unit, University Hospital of Martinique, Fort-de-France, 97261 Martinique, France
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Intensive Care Unit, Cayenne General Hospital
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Department of Emergency Medicine, University Hospital of Martinique, Fort-de-France, 97261 Martinique, France
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Emergency Medical Services (Service d’aide médicale d’urgence 972), 97261 Martinique, France
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Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Paris-Diderot University, INSERM UMR-S 1144, 75013 Paris, France
*
Author to whom correspondence should be addressed.
Toxics 2020, 8(2), 28; https://doi.org/10.3390/toxics8020028
Received: 23 February 2020 / Revised: 7 April 2020 / Accepted: 8 April 2020 / Published: 9 April 2020
(This article belongs to the Section Toxicology and Public Health)
The epidemiology of severe acute poisonings in the French overseas departments of the Americas remains poorly reported. The main objective of this study was to determine the epidemiology and characteristics of severe acutely poisoned adult patients. Methods: A retrospective descriptive study was conducted from 1 January 2000 to 31 December 2010 in severely poisoned patients presenting to the emergency department (ED) of the University Hospital of Martinique, and the general public hospitals of Lamentin and Trinité. Results: During the study period, 291 patients were admitted for severe poisoning, giving an incidence rate of 7.7 severe cases/100,000 inhabitants. The mean age was 46 ± 19 years and 166 (57%) were male. Psychiatric disorders were recorded in 143 (49.8%) patients. Simplified Acute Psychological Score (SAPS II) at admission was 39 ± 23 points and Poisoning Severity Score (PSS) was 2.7 ± 0.8 points. Death was recorded in 30 (10.3%) patients and hospital length of stay was 6 ± 7 days. The mode of intoxication was intentional self-poisoning in 87% of cases and drug overdose was recorded in 13% of cases. The toxic agent involved was a therapeutic drug in 58% and a chemical product in 52% of cases. The predominant clinical manifestations were respiratory failure (59%), hemodynamic failure (27%), neurologic failure (45%), gastrointestinal manifestations (27%), and renal failure (11%). Polypnea, shock, ventricular fibrillation or tachycardia, and gastro-intestinal disorders were the main symptoms associated with death. The main biological abnormalities associated with death in our patients were metabolic acidosis, hypokalemia, hyperlactatemia, hypocalcemia, renal injury, rhabdomyolysis, increased aspartate aminotransferases, and thrombocytopenia. Extracorporal membrane oxygenation (ECMO) was used in three patients and specific antidotes were used in 21% of patients. Conclusions: Acute poisonings remain a major public health problem in Martinique with different epidemiological characteristics to those in mainland France, with a high incidence of poisoning by rural and household toxins. View Full-Text
Keywords: epidemiology; acute poisonings; intensive care unit; Martinique epidemiology; acute poisonings; intensive care unit; Martinique
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Resiere, D.; Kallel, H.; Oxybel, O.; Chabartier, C.; Florentin, J.; Brouste, Y.; Gueye, P.; Megarbane, B.; Mehdaoui, H. Clinical and Epidemiological Characteristics of Severe Acute Adult Poisoning Cases in Martinique: Implicated Toxic Exposures and Their Outcomes. Toxics 2020, 8, 28.

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