Cambios epidemiológicos en las intoxicaciones atendidas en los servicios de urgencias pediátricos españoles entre 2001 y 2010: incremento de las intoxicaciones etílicas

Objective: To analyze changes in the epidemiology of poisonings attended in Spanish pediatric emergency departments in the last decade. Methods: Comparative study with historical control group. The characteristics of poisoning cases were extracted from the records of hospital emergency departments participating in the working group on poisonings of the Spanish Society of Pediatric Emergency Medicine (GTI-SEUP). We studied 2 groups comprised of cases from 2 periods: January 2001 to December2002 (data from the paper records of 17 departments) and October 2008 to September 2010 (data from the computerized records of 38 departments). Results: The frequency of poisoning among all emergencies attended was higher in the second period (0.33%) than in the first (0.28%) (P=.0076). In both periods around 75% of poisonings occurred in children aged 6 years or under (78.3% in the first period and 73.8% in the second). Medicines were the substances most often involved (54.7% and 51.6% in the first and second periods, respectively). The individual substances most often ingested were paracetamol in 2001-2002 and ethanol in 2008-2010. Ethanol poisonings increased from 7.5% of all cases in the first period to 16% in the second (P<.00001); abuse of illegal drugs (mainly cannabis) was associated with alcohol poisoning in nearly 9% of the cases. A third of the patients were discharged after initial evaluation and treatment. Conclusions: Involuntary ingestion of a medicine by a child under the age of 6 years continues to be the main cause of acute poisoning in Spanish pediatrics, although poisoning due to recreational use of alcohol has increased significantly. Ethanol is now the main single toxic substance implicated in cases of acute poisonings attended by Spanish pediatric emergency departments.