O-46 Clinical and Epidemiological Characteristics of Severe Acute Intoxications in Martinique (2011-2020)

Methods: We conducted a descriptive, retrospective, monocentric study. All patients admitted to the emergency department and intensive care unit of the University Hospital Center of Martinique over a 10-year period (2011-2020) for severe acute intoxication were included.

Results: A total of 241 patients were admitted for severe acute intoxication, with an incidence of 6.9 cases per 100,000 inhabitants. The median age of patients was 56 years [IQR, 39-72], with an almost equal gender distribution (51% women/49% men). Of these intoxications, 60% were voluntary and 40% were accidental drug overdoses. The toxic substances involved included drugs in 88% of cases and chemicals in 29%. Specific antidotes were administered in 33% of patients, and 5 patients received extracorporeal membrane oxygenation (ECMO). The median hospital stay was 10 days [4-25]. Mortality was 15%, with 35 patients dying at a median age of 73 years [59-79]. Factors associated with a fatal outcome included arterial hypotension (p = 0.003), shock (p < 0.0001), hyperlactatemia (p = 0.002), acute renal failure (p < 0.0001), elevated troponins (p < 0.0001), hepatic cytolysis (p = 0.003), and thrombocytopenia (p = 0.02). Drug overdose accounted for 83% of deaths, with the main lethal toxic agents being metformin (10 cases), cardiovascular drugs (10 cases), anticoagulants (7 cases), and psychotropics (5 cases).

Conclusion: Severe acute poisoning remains a major public health concern in the French Departments of America. In Martinique, although the incidence of serious poisoning appears to have fallen, the mortality rate has risen, mainly due to metformin overdoses. This epidemiological trend could be explained by changes in socio-environmental factors, such as an aging population and multimorbidity.