title: Acute Poisonings Admitted to a Tertiary Level Intensive Care Unit in Northern India: Patient Profile and Outcomes.
abstract: BACKGROUND
  Poisoning is becoming a real health care burden for developing countries like India. An improved knowledge of the patterns of poisonings, as well as the clinical course and outcomes of these cases can help to formulate better preventive and management strategies.
  
  
  OBJECTIVE
  To study the demographic and clinical profiles of patients admitted to the ICU with acute poisoning and to study the factors that predict their mortality.
  
  
  METHODS
  Retrospective two years (September 1, 2010 to August 31, 2012) study of all consecutive patients admitted to the Intensive Care Unit (ICU) with acute poisoning at a tertiary care hospital in Northern India.
  
  
  RESULTS
  Out of the 67 patients admitted to the ICU during the study period, the majority were young (median age 29 years) males (69%) who had consumed poison intentionally. Pesticides were the most commonly employed poison, notably organophosphorus compounds (22 patients, 32.8%) and aluminium phosphide (14 patients, 20.9%). While the overall mortality from all poisonings was low (18%), aluminium phosphide was highly toxic, with a mortality rate of 35%. The factors at ICU admission that were found to be associated with a significant risk of death were, high APACHE II and SOFA scores (p =0.0001 and p=0.006, respectively), as well as the need for mechanical ventilation and drugs for vasoactive support (p=0.012 and p= 0.0001, respectively).
  
  
  CONCLUSIONS
  Use of pesticides for intentional poisoning continues to be rampant in Northern India, with many patients presenting in a critical condition to tertiary level hospitals. Pesticide regulations laws, educational awareness, counseling and poison information centers will help to curtail this public health problem.
authors.affiliation: Assistant Professor, Department of Anesthesia and Critical Care, Christian Medical College and Hospital , Ludhiana, Punjab, India .
authors.forename: Hemani
authors.initials: H
authors.lastname: Ahuja
authors.affiliation: Professor, Department of Anesthesia and Critical Care, Christian Medical College and Hospital , Ludhiana, Punjab, India .
authors.forename: Ashu Sara
authors.initials: AS
authors.lastname: Mathai
authors.affiliation: Biostatistician, Department of Neurology, Christian Medical College and Hospital , Ludhiana, Punjab, India .
authors.forename: Aman
authors.initials: A
authors.lastname: Pannu
authors.affiliation: Consultant Eye Surgeon, Department of Ophthalmology, Dr Rohit Eye Care Hospital , Jagraon, India .
authors.forename: Rohit
authors.initials: R
authors.lastname: Arora
keywords: Mortality; Organophosphate poisonings; Phosphide; Poisoning agents