Clinical profile and outcomes of patients with acute poisoning presenting to the medicine emergency

Objectives Acute poisoning remains a significant public health issue in low- and middle-income countries, including India. The primary objectives of this study were to assess the clinical and epidemiological profile, spectrum of toxic agents, associated laboratory abnormalities, and short-term outcomes among patients presenting with acute poisoning at a tertiary care hospital. The secondary objective was to evaluate the utility of urine toxicology screening in cases with an unclear poisoning history. Material and Methods This prospective observational study was conducted over 18 months (April 2024 to August 2025) in the Medicine Emergency Department of a tertiary care hospital in East Delhi. A total of 177 patients with acute poisoning were enrolled. Clinical details, demographic data, poisoning characteristics, and outcomes were analyzed. Urine toxicology screening was performed in cases with unknown poisoning. Results The study cohort showed a slight female predominance (55.9%), with the 20–29 years age group most affected (40.7%). The mean age was 28.26 ± 11.32 years. A vast majority (87.6%) of cases were from urban areas. Pharmaceutical drug overdose (28.8%) was the most common poisoning agent, followed by aluminum phosphide (12.9%) and organophosphates (10.2%). Suicidal intent accounted for 71.8% of cases. The majority of poisonings were oral (99.4%) in route. The overall mortality rate was 6.2%, with higher mortality associated with low Glasgow coma scale (GCS) scores, vasopressor requirement, mechanical ventilation, and organ dysfunction. The highest mortality was observed in organophosphate poisoning (accounting for 36.4% of total deaths). Early presentation and supportive care improved outcomes. Urine toxicology screening identified benzodiazepines (2.8%), barbiturates (0.6%), and cannabinoids (0.6%) in a small subset of cases. No statistically significant correlation was found between toxicology results and outcomes. Conclusion This study indicates that acute poisoning in urban Delhi predominantly affects young adults, mainly females, and is increasingly driven by pharmaceutical overdoses with suicidal intent. Organophosphates had the highest fatality rate. Early medical intervention remains crucial for improved survival. Clinical factors such as low GCS and organ dysfunction are strong predictors of poor outcomes. Urine toxicology screening may be used as an adjunctive diagnostic tool in cases of unknown substance ingestion; however, its prognostic utility should be interpreted with caution.