Ten years’ experience of paediatrics acute drug poisoning in a tertiary center in Hong Kong

Background: The pattern of acute drug poisoning varies over time among different localities and populations but there has been a lack of up-to-date local data in paediatric population. This study examined the 10-year trend of paediatric acute drug poisoning in Hong Kong and aimed to identify risk factors associated with Paediatric Intensive Care Unit (PICU) admission. Methods: This retrospective study reviewed children and adolescents aged 0–18 years who were admitted for acute drug poisoning to Princess Margaret Hospital in Hong Kong between 2012 and 2021. Logistic regression and multi-variable analysis were used to identify independent risk factors for PICU admission. Results: In the past decade, an increasing trend with a younger age of onset (from 13.2 to 10.8 years old) was observed in abusive drug poisoning involving the use of anti-depressants and psychotropic medications. A new trend of abusing calcium channel blockers (CCBs) for suicidal attempt was identified. The top five most common drug categories for poisoning were paracetamol (33.8%), anti-depressants/psychotropic medications (24.4%), anti-histamines/cold medications (22.1%), benzodiazepines (8.4%), and anti-hypertensives (6.5%). Multiple drug poisoning [adjusted odds ratio (OR) 2.59, P=0.02] and anti-hypertensives poisoning (adjusted OR 10.84, P<0.001) were identified as independent risk factors for PICU admission. Mortality has resulted from a deliberate massive overdose of selective serotonin reuptake inhibitors (SSRIs). Conclusions: There was an increasing trend in paediatric acute drug poisoning involving the use of anti-depressants and psychotropic medications in Hong Kong. Multiple drug poisoning and anti-hypertensives poisoning were identified as independent risk factors for PICU admission.