Epidemiologic characteristics of poisoning among hospitalized children in Shanxi, a north Chinese city during 2008-2013

Background: Intentional and unintentional poisoning is a frequently occurred injury in childhood throughout the world, which is a common reason for referrals to hospital and affecting children health profoundly. There are different patterns of poisoning due to substantial differences in socioeconomic and cultures in different countries regions, which may influence the principle of prevention and therapy. In the present study, we aimed to elucidate the epidemiologic characteristics of poisoning among hospitalization children in a region located in the north of China. Methods: This was a retrospective analysis for hospitalized poisoning children who were under 14 years old. Five hundred and forty-nine person-times who were diagnosed with poison were included. This case series study was performed over a period of 6-year (January 2008 to December 2013) in seven large tertiary hospitals at Shanxi Province. Descriptive statistics were used to analyze the patient population characteristic, for example gender, age, regions of living. Chi-squared test, nonparametric rank sum test, independent sample t-test, or ANOVA were used to analyze the characteristics of poisoning and hospitalized in groups, Furthermore, associations between each indicator of the characteristics were analyzed using Spearman’s correlation analysis. Effect factors of LOS and cost were analyzed by multivariate linear regression. Results: In this study, total 549 hospitalized cases due to poisoning from January 1, 2008 to December 31, 2013 were collected. Among them, more than half were boys (56.3%) and the most children were under 5 yrs old (55.2%). Unintentional poisoning accounted for 95.8% of total cases. The common site of poisoning mainly occurred in home (95.6%) of total cases. The top three poisoning agents were drugs (47.1%), CO (21.9%) and pesticide (17.3%). Specially, the percentage of pesticide poisoning (21.4%) was found higher in rural than urban (10.6%). For the disease severity of poisoning, 50.3% were moderate with prolonged symptoms or signs. It was found that the percentage constituent of severe poisoning in intentional poisoning (47.8%) patients was significantly higher compared to that in unintentional poisoning (29.7%). The average length of stay (LOS) in the hospital was 4.82 d. The average hospitalization cost of individual poisoning case was 4170.81 yuan RMB. The results from Spearman’s analysis indicated both LOS (rs = 0.131, P < 0.01) and cost (rs = 0.110, P < 0.01) increased with age; while the constituent of unintentional poisoning (rs = -0.628, P < 0.001) decreased with age. Multivariable linear regression was also conducted and the result from this analysis indicated that drug poisoning, age, food poisoning, and cleaner poisoning were the main effect factors contributing to LOS among the poisoning hospitalized children. In addition, the main effect factors of cost were LOS, drug poisoning, and disease severity among the poisoning hospitalized children. The overall fatality rate was 1.5% (4.5% intentional; 1.4% unintentional). Conclusions: The younger children are the high-risk population for poisoning with the most of unintentional poisoning, and the drug is the common agent. On the other hand, in the adolescents, there are higher risks of pesticide poisoning in intentional poisoning. Moreover, in this population, the disease severity, LOS and hospitalization cost increase as well.