ABSTRACT
Childhood poisoning is a prevalent and significant public health issue, with a higher incidence among children under the age of five due to their natural inquisitiveness and impulsive behavior. In order to gain a better understanding of the burden and outcomes of acute poisoning in children, this study utilized data from two comprehensive databases: the 2018 Nationwide Emergency Department Sample and the National (Nationwide) Inpatient Sample. A total of 257,312 hospital visits were analyzed, with 85.5% being emergency department visits and 14.5% being inpatient admissions. Drug overdose emerged as the most commonly known cause of poisoning in both emergency and inpatient settings. While alcohol poisoning was the predominantly known cause of non-pharmaceutical poisoning in the inpatient setting, household soaps and detergents were more common in the emergency setting. Among the identified pharmaceutical agents, non-opioid analgesics and antibiotics were the most frequently implicated. However, a significant proportion of the poisoning cases were caused by unidentified substances (26.8% in the pharmaceutical group and 72.2% in the non-pharmaceutical group). There were 211 deaths in total and further analysis revealed that patients with higher Charlson indices and hospital stays exceeding seven days were associated with increased likelihood of mortality. Additionally, admission to teaching hospitals or hospitals located in the western region of the country was linked to an increased likelihood of an extended hospital stay.
ABSTRACT
The present network meta-analysis was conducted to compare typical and atypical antipsychotics for the management of intensive care unit (ICU) delirium. The present meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two investigators systematically searched electronic databases, including PubMed, EMBASE, and the Cochrane Library, for relevant studies in English from inception to February 15, 2023. The key terms used to search for relevant articles included "antipsychotic," "delirium," "randomized-controlled trials," and "efficacy." We used the term "randomized controlled trials (RCTs)" to limit the search to RCTs. The primary outcome was the duration of delirium in days. There were three predefined secondary outcomes included: mortality in 30 days, duration of mechanical ventilation in days, and length of ICU stay in days. A total of seven studies were included in the present meta-analysis. No significant difference was found between typical anti-psychotic, atypical anti-psychotic, and placebo in terms of duration of delirium, rate of mortality, duration of ICU stay, and duration of mechanical ventilation. In conclusion, this network meta-analysis comparing typical antipsychotic, atypical antipsychotic medications, and placebo on delirium in patients in the ICU did not find evidence that either typical or atypical antipsychotic medications led to a shorter duration of delirium. Patients who received treatment with typical or atypical antipsychotics and those who received a placebo had similar clinical outcomes, including mortality, length of stay in the ICU, and duration of ventilation.
