Epidemiology, Severity, and Associated Factors of Poisoning Cases and Patient Outcomes

Background and aims: Poisoning represents a significant public health concern in the developing world. This study aimed to investigate the epidemiology, severity, and factors associated with poisoning incidents in the rural regions of western India. Methods: The required data were retrospectively collected from patients admitted to a private 20-bed rural hospital located in Pune, India, for acute poisoning between 2015 and 2019. The study examined patient characteristics, routes and types of exposure, and associated outcomes. Severity assessments were conducted using the Poison Severity Score (PSS) and the Glasgow Coma Scale (GCS) poisoning severity systems. Statistical analyses were performed using the Kruskal-Wallis and chi-square tests. Results: Overall, 386 cases of poisoning were analyzed in this study. The primary sources of poisoning were accidental incidents or envenomation (48.9%), followed by intentional poisoning (42.2%). Poisoning of unknown origin accounted for 8.8% of cases. In terms of the route of exposure, bites or stings (50.7%) were the most common, followed by ingestion (48.7%) and inhalation (0.5%). According to the GCS, mortality was observed in 33% of patients with severe poisoning compared to 15% of those with moderate-grade poisoning. Based on the PSS, 10.5% of patients classified with severe grades of poisoning experienced mortality. All patients with mild severity of poisoning survived and were subsequently discharged from the hospital. An intermediate correlation was observed between GCS and PSS (r=0.54, P≤0.001). The overall mortality rate was 3.6% (14 out of 386), while six patients were discharged against medical advice. Conclusion: The findings revealed that the outcomes of poisoning incidents are influenced by patient characteristics, the nature of toxic exposure, and access to an adequate quality of care. Both the GCS and the PSS are effective in predicting clinical severity in patients with poisoning. However, the PSS would benefit from modifications to account for cardiovascular and neurological variables.