| Objective:.The clinical data of all patients with acute poisoning admitted to the Affiliated Hospital of Southwest Medical University from January 2016 to December 2020 were retrospectively analyzed through clinical diagnosis data and diagnosis and treatment data.It is clear that:1.Describe the demography,clinical epidemiology and seasonal trend of patients treated for poisoning;2.To explore the related factors affecting the prognosis of patients with poisoning;3.To establish a model for predicting the risk of survival and prognosis of poisoning patients.Methods:We collect general relevant clinical research data of acute poisoning patients who were admitted to the Affiliated Hospital of Southwest Medical University from January 2016 to December 2020.At the same time we collecting general sociological demographic data of patients with acute poisoning.The main content includes the gender,age,marital status,occupation,address and main types of poisoning,the time of poisoning(year and month),and the time from poisoning to hospital admission(hour),The duration of the hospitalization,the expenses incurred in the hospitalization,whether gastric lavage,whether to perform blood purification,and the outcome of the disease,etc.we use SPSS 25.0 statistical software for statistical description and inference.Quantitative data are represented by mean,standard deviation,median,and interquartile range.Qualitative data is expressed by frequency and percentage.Chi-square test was used to compare qualitative data between groups.Independent sample t-test was used to compare quantitative data between groups.Multivariate logistic regression model was used to explore the factors related to the prognosis of patients.Binary logistic regression model combined with 5-fold cross-validation(5foldcrossvalidation)was used to establish a poisoning prognosis risk prediction model based on general demography,poisoning-related characteristics and organ involvement.The test level is α = 0.05,and the difference is considered to be statistically significant when P < 0.05.Results:1.In this study,a total of 2121 cases of acute poisoning were collected and the ratio of male to female patients was 1040 to1081.The number of female patients was more than that of male patients.The average age of patients with acute poisoning was 42.44±20.20 years old.The high incidence age group was the young group which were 18 to 44 years old with a total of 682 cases(35.5%).There were 535 cases(27.9%)in the middle-aged group which were 45 to 59 years old.There were 427 cases(22.3%)in the elderly group which were older than or equal to 60 years old.There were 275 cases(14.3%)in the elderly group which were less than or equal to 17 years old.The occupational distribution is that there are 733 farmers and workers.There were 733 farmers(35.5%)and 543 workers(25.6%).The marital status is mainly married,1444 cases are married accounting for 68.1%.The most poisoned areas were in Jiangyang District with 321 cases(15.1%).The number of people who came to hospital for poisoning in2016,2017,2018,2019 and 2020 were 444,361,369,417,335 respectively.2.The description of poisoning-related characteristics of poisoning patients showed that the average time from poisoning to admission of 2121 patients was 5.60 ±8.63 hours and the median and quartile interval between poisoning and admission was 3.00(1.00,6.00)hours.1076 patients(50.7%)underwent gastric lavage and 912patients(43.0%)were treated with hemoperfusion.There were 1040 cases of active poisoning(49.0%)and 1091 cases of passive poisoning(51.0%).There were 389 patients with mental disorders(18.3).The average hospitalization time of patients with acute poisoning was 5.55±6.26 days and the average hospitalization cost was 11991.31±15885.58 yuan.The top three poisoning types were pesticide poisoning in 892 cases(42.1%),drug poisoning in 311 cases(14.7%)and toxic animal injury in 311 cases(14.7%).3.The average hospital stay was 5.55 ±6.26 days and the median and quartile interval of length of stay is 4.00(2.00 and 7.00)days.The average hospitalization cost is11991.31 ±15885.58 yuan and the median and quartile interval of hospitalization cost is 6671.24 yuan(3581.70 yuan 13997.61).There were 1788 cases of improvement(84.3%),138 cases of death(6.5%)and 195 cases(9.2%)of voluntary discharge.Among the 2121 patients,the number of patients involving digestive tract,respiratory system,blood coagulation system,brain,kidney,liver and heart was 190(9.0%),129(6.1%),300(14.1%),193(9.1%),274(12.9%),401(18.9%),650(30.6%)respectively.Among them,964 patients had no organ involvement,accounting for 45.5%.4.Comparison of the characteristics of patients with good and poor prognosis: the proportion of males in the death group was higher,and the average age was older,and the difference was statistically significant.There was no significant difference in marital status and occupation between the two groups.In the death group,the proportion of patients with gastric lavage and hemoperfusion was relatively high and the proportion of patients with active poisoning was relatively high and the differences were statistically significant.In addition,there was a statistically significant difference in the distribution of poisoning types and subtypes of pesticide poisoning between the two groups that is the mortality rate of pesticide poisoning was the highest in the poisoning type which accounting for 93 deaths and accounting for 11.7%.Among the patients poisoned by paraquat,the mortality rate was the highest with 43 deaths and accounting for 29.7%.The proportion of patients with accumulated respiratory system,blood coagulation,brain,kidney,liver and heart in the death group was significantly higher than that in the improvement group and the difference was statistically significant and the number of accumulated organs in the death group was significantly higher than that in the improvement group and the difference was statistically significant.There was no significant difference in the proportion of accumulated digestive tract between the two groups.5.The results of multivariate Logistic regression analysis showed that the relationship between age,active poisoning,respiratory system,blood coagulation system,brain,kidney,liver,heart and prognosis was statistically significant.6.To predict the prognosis of patients with acute poisoning: the mean of Youden index is 0.86,the mean of sensitivity is 0.926,the mean of specificity is 0.93 and the mean of specificity is 0.953 which indicates that the model has good stability.Conclusion:1.2121 cases of acute poisoning in our hospital were more female than male,and the high incidence of acute poisoning was at the age of 18 to 44 years old,with the largest number of farmers among the acute poisoning patients treated in our hospital.The marital status of married patients was the first,and pesticide poisoning was the most common type of poisoning.2.Age,active poisoning,involvement of respiratory system,involvement of blood coagulation system,involvement of brain,kidney,liver and heart were independent risk factors affecting prognosis.3.The prediction model of poisoning prognosis risk constructed in this study has a certain guiding significance for identifying highrisk groups,and provides a new reference method for clinical evaluation. |
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