Objectives: Aim of our study was to analyze toxic related deaths occurred in the past in our Toxicology Unit. Victims’ demography and their distribution by age, class and nature of offenders involved in deaths, overall and adjusted by class mortality rate (MR), and time to death were reported. Methods: We retrospectively analyze available data related to deaths occurred in patients admitted for acute poisonings, between 1924-1960, consulting the archives of our old medical records. Results: a total of 7,435 patients were admitted; out of these, 260 died. Gender was registered in 254 out of 260 cases (132 female and 122 male, 52% and 48%, respectively). Victims’ age ranged 2-94 years, and overall mean age ± SE was 44.1 ± 1.2 years (female 41.2 ± 1.6, male 47.5 ± 1.7). Death’s distribution by classes of age (range 2–94 ys) were 1.6% (0 to 5 ys), 9.3% (6 to 20 ys), 49.6% (21 to 50 ys), 32.5% (51 to 70 ys), and 7.3% over 71 ys. Overall MR resulted 3.49%. Multiple different xenobiotics were involved in deaths. The five most represented fatal classes of offenders were: caustics (n 90; 34.6%), barbiturates (n 73; 28.5%), mercuric dichloride (corrosive sublimate) (n 26; 10%), systemic toxic gases (n 25; 9.6%) and arsenic salts (n 11; 4.2%). The MR value adjusted according to prior class of toxics show the higher value for arsenic salts (33.3%) followed by mercuric dichloride (32.9%), barbiturates (10.9%), caustics (8.5%) and systemic toxic gases (4.8%). Sex distribution ratio (male/female) was: caustics 0.84, barbiturates 1.25, corrosive sublimate 0.3, systemic toxic gases 1.2, arsenic salts 2.7. Overall mean±SE time (days) between admission and death was 3.03 ± 0.17, varying by the class of toxics as follows: 1.1 ± 0.5 systemic toxic gases, 1.7 ± 0.2 caustics, 2.7 ± 0.8 arsenic salts, 3.9 ± 0.3 barbiturates, 7.4 ± 0.6 mercuric dichloride. Conclusions: The retrospective analysis of this old death case series due to acute poisonings showed a significant higher MR than reported in contemporary ones. To explain these data, we must consider the different offenders, the lack of supportive care therapy and decontaminating techniques and effective antidotes.
Once upon a time the toxic related deaths: A case series from 1924 to 1960 / Gambassi, Francesco; Botti, Primo; Ieri, Alessandra; Pracucci, Chiara; Bertieri, Lara; Missanelli, Andrea; Orsini, Isabella; Mannaioni, Guido; Masini, Emanuela. - In: CLINICAL TOXICOLOGY. - ISSN 1556-3650. - STAMPA. - (2015), pp. 264-264.
Once upon a time the toxic related deaths: A case series from 1924 to 1960
MANNAIONI, GUIDO;MASINI, EMANUELA
2015
Abstract
Objectives: Aim of our study was to analyze toxic related deaths occurred in the past in our Toxicology Unit. Victims’ demography and their distribution by age, class and nature of offenders involved in deaths, overall and adjusted by class mortality rate (MR), and time to death were reported. Methods: We retrospectively analyze available data related to deaths occurred in patients admitted for acute poisonings, between 1924-1960, consulting the archives of our old medical records. Results: a total of 7,435 patients were admitted; out of these, 260 died. Gender was registered in 254 out of 260 cases (132 female and 122 male, 52% and 48%, respectively). Victims’ age ranged 2-94 years, and overall mean age ± SE was 44.1 ± 1.2 years (female 41.2 ± 1.6, male 47.5 ± 1.7). Death’s distribution by classes of age (range 2–94 ys) were 1.6% (0 to 5 ys), 9.3% (6 to 20 ys), 49.6% (21 to 50 ys), 32.5% (51 to 70 ys), and 7.3% over 71 ys. Overall MR resulted 3.49%. Multiple different xenobiotics were involved in deaths. The five most represented fatal classes of offenders were: caustics (n 90; 34.6%), barbiturates (n 73; 28.5%), mercuric dichloride (corrosive sublimate) (n 26; 10%), systemic toxic gases (n 25; 9.6%) and arsenic salts (n 11; 4.2%). The MR value adjusted according to prior class of toxics show the higher value for arsenic salts (33.3%) followed by mercuric dichloride (32.9%), barbiturates (10.9%), caustics (8.5%) and systemic toxic gases (4.8%). Sex distribution ratio (male/female) was: caustics 0.84, barbiturates 1.25, corrosive sublimate 0.3, systemic toxic gases 1.2, arsenic salts 2.7. Overall mean±SE time (days) between admission and death was 3.03 ± 0.17, varying by the class of toxics as follows: 1.1 ± 0.5 systemic toxic gases, 1.7 ± 0.2 caustics, 2.7 ± 0.8 arsenic salts, 3.9 ± 0.3 barbiturates, 7.4 ± 0.6 mercuric dichloride. Conclusions: The retrospective analysis of this old death case series due to acute poisonings showed a significant higher MR than reported in contemporary ones. To explain these data, we must consider the different offenders, the lack of supportive care therapy and decontaminating techniques and effective antidotes.
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