Système gastro-intestinal et digestif

Abstrait

Rat Killer Poisoning vs Liver Damage: A View in South Indian Patients of Tertiary Care Center

Radhika Venugopal, Krishnasamy Narayanasamy, Chezhian A, Senthil Kumar R and J. Janifer Jasmine*

Background: Rodenticide ingestion is common suicidal poisoning. In the absence of antidote, consumption is fatal. We aimed at socio-demographic characteristics, analyzed predictive factors, biological elevation curve and its outcome. Methods: 101 patients admitted with rodenticide poisoning. Socio-demographic characteristics, probable predictive factors, Serial charting biological markers recorded. Standard care management was given. Results: Of the 101 patients 76% were from rural and 24% urban. 62% were female and male 38%. Mean age was 26.0 ± 10.467 years. Unmarried men and married women were higher. Higher number was literate 46% and Illiterate 28%. Higher number was salaried 45% and students 30%. 34% consumed raw, 30% mixed with water. 57% ingested <10 grams, 24% up to 20 and 20%, >20 grams. Mean dosage of 13.42 ± 7.069 grams. Mean care seeking time 6.0 ± 6.3702 hours. 46% sought <3 hours, 41% in 10 and 13% >10 hours. Chief symptom was vomiting in 33% patients, abdominal pain 36%, headache 27% and oral bleeding 4%. Biological markers in survivor and non-survivor showed, T bill, Albumin, AST, ALT, Creatinine, PT, INR and MELD were statistically significant. T protein, platelet and urea were not significant. 9 patients had MELD <10, 30-(11-20), 35-(21-30) and >30 MELD was in 27. All of those had a MELD of >40 died. 41% had toxic hepatitis, 21% acute liver failure, 19% toxic hepatitis with acute kidney injury/ALF with acute kidney injury and 19% developed multiple organ failure. Overall mortality rate was 19%, 81% recovered with 8.88 days mean hospital stay. Conclusions: Patient ingested yellow phosphorus had liver damage. Lethal dosage and late presentation to medical facility led to liver failure, multiple organ failure and mortality in spite of standard care. Creating awareness, promoting mental health, suicide prevention and framing proper guidelines of treatment are best cornerstones to reduce mortality by rat killer poisoning.