Pınar ACUN, Burcu DENİZLİOĞLU, Yoldaş DEMİRTAŞ, Ersin AKSAY, İsmail YILMAZ

Bir Eğitim Hastanesinde Parasetamol ile İntihar Girişiminde Bulunan Hastaların Demografik Özellikleri

Amaç: Parasetamol içeren preparatların çeşitliliği ve yaygın olması, suicid amaçlı kullanılmaihtimalini artırır. Bu retrospektif çalışmada, parasetamol intoksikasyonuyla gelen hastalarınklinik ve demografik özelliklerininin ortaya konulması amaçlanmıştır.Yöntem ve Gereç: Çalışmaya parasetamol zehirlenmesi ön tanısı ile 1 Ocak–31 Aralık 2009tarihleri arasında İzmir Bozyaka Eğitim ve Araştırma Hastanesi Acil Ünitesine başvuran 214hasta dahil edilerek hastaların demografik ve klinik verileri toplanmıştır.Bulgular: Vakaların büyük bir kısmını 20 yaşın altında hastalar oluşturmuştur (78 hasta,%36.4).Başvuruların 22:00-23:00 ve 00:00-01:00 saatleri arasında yoğun olduğu görülürken, Haziranayında diğer aylara oranla daha fazla vakanın acile başvurduğu görüldü. Olguların 55’i (%26)sadece parasetamol, 159’u (%74) ise parasetamolü diğer ilaçlar ve/veya alkol ile birlikte almıştır.İntoksikasyon semptomları 174 hastada (%81) mevcutken, 40 hastada (%19) herhangi birintoksikasyon belirtisi yoktu.Sonuç: Hastaların demografik bilgilerinin iyi bilinmesi ve Zehir Danışma Merkezlerinin etkinkullanımı, parasetamol zehirlenmesinin tanı ve tedavisinin geliştirilmesinde faydalı olabilir

Anahtar Kelimeler:

Parasetamol, zehirlenme, intihar, demografik bilgiler

Demographic Characteristics of Patients, who Attempted Suicide with Paracetamol in a Research Hospital

Purpose: Diversity and widespread availability of paracetamol containing preparations increasethe likelihood of their use for suicidal attempts. This retrospective study aimed to provideinformation regarding the clinical and demographic characteristics of patients with paracetamolintoxication.Material and Methods: A total of 214 patients attending to the Emergency Unit of the IzmirBozyaka Training and Research Hospital between 1 January–31 December 2009 with apreliminary diagnosis of paracetamol intoxication were included. Demographic and clinicaldata have been collected.Results: Patients younger than 20 years of age represented the majority (78 patients, 36.4%) ofthe cases. Most of the emergency visits were recorded between 22:00 and 23:00 p.m. andbetween 00:00 and 01:00 a.m. Proportion of patients was highest in June as compared to othermonths. Of the whole study population, 55 (26%) ingested only paracetamol, while 159 (74%)were intoxicated with other drugs and/or alcohol as well. Symptoms were present in 174 patients(81%); 40 patients (19%) had no symptoms.Conclusions: Good knowledge of demographic data of the patients and effective use of poisoncall centers may help to improve diagnosis and management in paracetamol intoxication

Keywords:

Paracetamol, intoxication, suicide, demographic data,

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Shaffer D, Craft L. Methods of adolescent suicide prevention. J Clin Psychiatry 1999;60 Suppl 2:70-74; discussion 75- 76,113-116.
Linden CH. Acetaminophen; in Tintinalli JE (4th ed): Emergency medicine. 1995, 787-792.
Mert E, Bilgin NG. Demographical, aetiological and clinical characteristics of poisonings in Mersin, Turkey. Hum Exp Toxicol 2006, 25; 217-223.
Litovitz T, Klein-Schwartz W, White S: 2000 Annual Report Of The American Association Of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2000;19:337.
Kozer E, Koren G. Management of paracetamol overdose: Current controversies. Drug Saf 2001; 24:503-512.
Ashbourne JF, Olson KR, Khayam-Bashi H. Value of rapid screening for acetaminophen in all patients with intentional drug overdose. Ann Emerg Med 1989;18: 1035-1038.
Lai MW, Klein-Schwartz W, Rodgers GC, et al. 2005 Annual Report of The American Association of Poison Control Centers National Poisoning and Exposure Database. Clin Toxicol (Phila) 2006;44: 803-932.
Kurt I, Erpeg AG, Kurt MN, Gurel A. Poisoning cases followed at Adnan Menderes University. ADU Tıp Fak. Dergisi 2004;5: 37-40.
Gunnell D, Murray V, Hawton K. Use of paracetamol (acetaminophen) for suicide and nonfatal poisoning: Worldwide patterns of use and misuse. Suicide Life Threat Behav 2000;30:313-326.
Hocaoglu N, Kalkan S, Akgun A, Capar S, Tuncok Y. A retrospective evaluation of analgesic exposures from Izmir, Turkey. Hum Exp Toxicol 2007;26:629-636.
Karabulut N, Celik Z, Atalay C. Retrospective analysis of poisoning cases admitting to Artvin State Hospital. EAJM 2007; 39:198-201.
Uyanikoglu A, Zeybek E, Cordan I, Avcı S, Tukek T. Evaluation of intoxication cases. Nobel Medicus 2007; 3(2):18-22.
Yesil O, Akoglu H, Onur O, Guneysel O. Retrospective analysis of posioning cases admitting emergency department. Marmara Medical Journal 2008;21:26-32.
Deniz T, Kandis H, Saygun M, Buyukkocak U, Ulger H, Karakus A. An analysis of poisoning cases admitting the emergency department of Kırıkkale University Medical Faculty. Düzce Tıp Fakültesi Dergisi 2009;11:15-20.
Morgan OW, Griffiths C, Majeed A. Interrupted time-series analysis of regulations to reduce paracetamol (acetaminophen) poisoning. PLoS Med April 2007;4(4):e105.
Kavalci C, Durukan P, Cevik Y, Ozer M, Ikizceli I. Analysis of poisoning cases: A 1-year experience of a new hospital. Turkiye Acil Tıp Dergisi 2006;6:163-166.
Kaygusuz K, Gursoy S, Kilicoglu F, Ozdemirkol I, Mimaroglu C. Retrospective analysis of acute medicinal poisoning cases followed at cumhuriyet University Medical Faculty Hospital intensive care unit between 1998-2004). Cumhuriyet Universitesi Tıp Fakültesi Dergisi 2004;26:161-165.