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Hanif, Sadaf, Sohaib, Muhammad, Hirani, Sana, Fatima, Summaya, Buzdar, Ashraf, Sohail, Fatima, Khan, Fatima, Sethi, Sher. (1404). Twenty-year trends in ICU poisoning management with and without antidotes: experience from a tertiary hospital in Pakistan. , 15(1), 37-43. doi: 10.22038/apjmt.2026.89817.1528
Sadaf Hanif; Muhammad Sohaib; Sana Hirani; Summaya Fatima; Ashraf Buzdar; Fatima Sohail; Fatima Khan; Sher M Sethi. "Twenty-year trends in ICU poisoning management with and without antidotes: experience from a tertiary hospital in Pakistan". , 15, 1, 1404, 37-43. doi: 10.22038/apjmt.2026.89817.1528
Hanif, Sadaf, Sohaib, Muhammad, Hirani, Sana, Fatima, Summaya, Buzdar, Ashraf, Sohail, Fatima, Khan, Fatima, Sethi, Sher. (1404). 'Twenty-year trends in ICU poisoning management with and without antidotes: experience from a tertiary hospital in Pakistan', , 15(1), pp. 37-43. doi: 10.22038/apjmt.2026.89817.1528
Hanif, Sadaf, Sohaib, Muhammad, Hirani, Sana, Fatima, Summaya, Buzdar, Ashraf, Sohail, Fatima, Khan, Fatima, Sethi, Sher. Twenty-year trends in ICU poisoning management with and without antidotes: experience from a tertiary hospital in Pakistan. , 1404; 15(1): 37-43. doi: 10.22038/apjmt.2026.89817.1528

Twenty-year trends in ICU poisoning management with and without antidotes: experience from a tertiary hospital in Pakistan

Asia Pacific Journal of Medical Toxicology
مقاله 6، دوره 15، شماره 1، خرداد 2026، صفحه 37-43    اصل مقاله (258.82 K)
نوع مقاله: Original Article
شناسه دیجیتال (DOI): 10.22038/apjmt.2026.89817.1528
نویسندگان
Sadaf Hanif1؛ Muhammad Sohaib2؛ Sana Hirani3؛ Summaya Fatima4؛ Ashraf Buzdar4؛ Fatima Sohail5؛ Fatima Khan4؛ Sher M Sethi* 6
1Senior Instructor, Internal Medicine & Critical Care, Aga Khan University Hospital, Karachi, Pakistan
2Anesthesia & Critical Care, Aga Khan University Hospital, Karachi, Pakistan
3Clinical Nurse Specialist, Internal Medicine & Nursing Division, Aga Khan University Hospital, Karachi, Pakistan
4Resident, Internal Medicine, Aga Khan University Hospital, Karachi, Pakistan
5Senior Medical Officer, Internal Medicine, Aga Khan University Hospital, Pakistan
6Instructor, Internal Medicine, Aga Khan University Hospital, Karachi, Pakistan
چکیده
Background: Poisoning is a major global health challenge and often requires intensive care due to high morbidity and mortality. We evaluate epidemiological trends, clinical features, and outcomes of adults admitted to the ICU with toxic exposures or substance misuse over 20 years.
Methods: We conducted a retrospective review at Aga Khan University Hospital, Karachi, including adults (≥18 years) admitted to the medical ICU between 2002 and 2022. Statistical analyses (Chi-square, Fisher’s exact, Mann-Whitney U, and logistic regression) assessed associations and predictors of mortality.
Results: Among 115 patients, most were young adults (18–30 years, 47%) and male (71.3%). Organophosphorus (OP) compounds were the most common (39.1%), followed by household bleach and paraquat (24.3%). Median ICU stay was 5 days, and hospital stay was 9 days. ICU mortality was 18.3%, with 81.7% surviving to discharge. Gastric lavage was performed in 23.5%, and antidotes in 65.2%, with slightly higher survival among recipients (66% vs. 61.9%). OP poisoning was linked to central nervous and cardiovascular complications, while methanol poisoning was strongly associated with acute kidney injury. Non-survivors had shorter ICU stays, more renal complications, higher vasopressor use (90.5%), and increased need for renal replacement therapy (52.4%). Logistic regression identified longer hospital stay (OR = 1.124, p = 0.044) and vasopressor use (OR = 0.029, 95% CI: 0.005–0.176) as significant mortality predictors.
Conclusion: Poisoning-related ICU admissions mainly affected young males, with OP compounds and methanol as leading toxins. Methanol poisoning and vasopressor requirement were strongly associated with mortality. Early recognition and aggressive management are essential for improving outcomes.
کلیدواژه‌ها
Antidotes؛ Intensive care units؛ Methanol؛ Organophosphates؛ Poisoning
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