Pediatr Emerg Med J.  2023 Oct;10(4):132-141. 10.22470/pemj.2023.00829.

Analysis of 2011-2020 intentional drug poisoning in children and adolescents

• Park JS
• Cho JS
• Woo JH
• Jang JH
• Choi WS
• Lim YS
• Choi JY

• KMID: 2546287
• DOI: http://doi.org/10.22470/pemj.2023.00829

Abstract

Purpose
We aimed to investigate the changing trends in intentional drug poisoning among pediatric and adolescent patients over the past 10 years.
Methods
A retrospective study was conducted on patients younger than 20 years who visited an academic hospital emergency department (ED) in Incheon, Korea, from January 2011 through December 2020. The study focused on patients who responded with “self-harm or suicide” in the ED-based Injury In-depth Surveillance, and whose injury mechanism was drug poisoning. Exclusion criteria were unintentional injuries and the ingestion of substances other than drugs. To describe the trend over the decade, we used the number of events/100,000 ED annual visits of the database.
Results
A total of 3,388 cases with a median age of 17 years (interquartile range, 15-18 years) were included. The most frequently ingested drugs were acetaminophen (27.8%), followed by benzodiazepines (15.2%), antidepressants (14.1%), other sedatives and hypnotics (13.4%), and antipsychotics (8.3%). As for the events/100,000 ED annual visits, benzodiazepines showed the biggest increase, from 7.6 to 80.2 cases. Similarly, antidepressants increased from 10.2 to 71.1 cases, and antipsychotics from 3.6 to 53.7 cases.
Conclusion
Intentional drug poisoning has increased over the past 10 years, particularly in benzodiazepines, antidepressants, and antipsychotics. It is advisable to establish injury prevention strategies according to patients’ characteristics and ingested drugs.

Keyword

Adolescent; Child; Emergency Service, Hospital; Intention; Poisoning

Figure

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  Fig. 1. The trend of intentional drug poisoning from 2011 through 2020. Both boys (shaded bar) and girls (open bar) show increases in their proportions throughout the period, especially since 2017. Moreover, increasing trends in both boys (solid line) and girls (dotted line) are noted in the events/100,000 ED annual visits (Ps for trend < 0.001; see numerical values in Table 2). ED: emergency department.

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  Fig. 2. Annual trends of age groups showing overall increases. The patients aged 18-19 years show the biggest increase in the events/100,000 ED annual visits (from 24.9 in 2011 to 118.4 in 2020). The other age groups show decreases from 2011 to 2017 and rebound increases thereafter. See more numerical values in Table 2. ED: emergency department.

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  Fig. 3. Trends of the events/100,000 ED annual visits and hospitalization. ED: emergency department, ICU: intensive care unit.

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  Fig. 4. Annual trends of intentional drug poisoning stratified by substance. Benzodiazepines show the biggest difference between 2011 and 2020, with similarly big differences in antidepressants and antipsychotics. ED: emergency department.

Reference

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