Outcomes in chloralose poisoning: A multivariate analysis of a retrospective cohort in an emergency department

Introduction. - Alphachloralose is a dangerous rodenticide and is still implied in a significant number of accidental or voluntary poisonings. This study aimed to describe the epidemiological features and outcomes of patients admitted for alphachloralose poisoning.Methods. - A twenty-four-month-long retrospective study, including all patients, admitted for chloralose poisoning in the emergency department (ED). Uni and multivariate analyses were realized to establish predictors of a severe clinical presentation. Results. - We have included 97 patients with a mean age of 24.5 + 13.5 years. Most of the cases were single (53.6%) and young (aged 15 to 25 years 42.3%); 87.6% of cases were voluntary sui-cide attempts. Thirteen patients had a psychiatric history (13.4%). The mean dose of ingested poison quantity (IPQ) was 4.08 + 3.45 g. The mean time between taking the toxic and hospi-tal admission was 2.4 + 1.4 hours. Neurological symptoms were the most frequent troubles on admission (45.2%). The severity grade was 1 in 48 patients, 2 in 17 patients (17.5%), 3 in 25 subjects (25.8%), and 4 in 7 patients (49.5%). Mechanical ventilation was required in 42 patients (43.3%). Digestive decontamination was performed in 75 patients (77.3%): gastric lavage in 69 cases (71.1%), and activated charcoal in 11 cases (11.3%). Independent predictors of clinical severity were age (P= 0.009; odds-ratio = 1.06; 95%CI [1,01-1.11]), and mean IPQ (P < 0,001; odds-ratio = 1.67; 95%CI [1.33-2.1]). Cut-off of IPQ predicting a severe to fatal presentation was at 3.25grams (P < 0.001; AUC = 0.85; sensitivity = 90.6%; specificity = 67.7%) Conclusion. - Chloralose poisoning is usually severe, often life-threatening, and justifies the admission of the patient into an intensive care unit. Determining the ingested dose is crucial to predicting the severity. Early management is also important to improve outcomes.(c) 2022 Soci acute accent et acute accent e Franc , aise de Toxicologie Analytique. Published by Elsevier Masson SAS. All rights reserved.