Acute Poisonings Admitted to the Intensive Care Unit of Cocody University Hospital, Côte d'Ivoire, Africa: Clinical Characteristics and Factors Associated With Intensive Care Unit Mortality.

BACKGROUND: Acute poisoning is a common reason for emergency department (ED) visits and intensive care unit (ICU) admission in sub-Saharan Africa. This study aimed to describe the clinical and toxicological characteristics of acute poisonings admitted to the ICU and to identify clinical and circumstantial factors associated with ICU mortality in Côte d'Ivoire. METHODS: This is a retrospective, observational, single-center study conducted from January 2020 to December 2022. All patients admitted to the ICU for acute poisoning were included. Sociodemographic, clinical, toxicological, and emergency management data were analyzed using Microsoft Excel 2016 (Microsoft Corp., Redmond, WA) and Epi Info 7.2 (CDC, Atlanta, GA). Chi-square or Fisher's exact tests were used (significance threshold: p < 0.05). RESULTS: Of 944 ICU admissions, 296 (31.4%) were for acute poisoning; 200 were analyzed after excluding incomplete records. All patients were initially assessed in the hospital emergency department before ICU transfer. The mean age was 17.4 ± 15.1 years; 53% were female; 48% were under 15 years. Voluntary ingestion accounted for 55% of cases. Caustic substances (48%), organophosphates (17%), and medications (14%) were the most common agents. The overall ICU mortality was 16%. Factors significantly associated with ICU death included age under 15 years (p = 0.005), petroleum product exposure (odds ratio (OR): 3.90 (1.37-11.10); p = 0.005), seizures (OR: 12.06 (5.37-27.26); p < 0.001), respiratory distress (OR: 2.37 (1.18-4.77); p = 0.043), cardiovascular collapse (OR: 6.09 (3.27-10.96); p < 0.001), and dehydration (OR: 26.35 (8.26-106.33); p < 0.001). Additional factors associated with death included delayed ED presentation (≥24 hours: OR: 14.40 (2.43-85.33); p = 0.004) and prehospital oil-based emetic use (OR: 2.08 (1.02-4.24); p = 0.04). CONCLUSION: Acute poisoning predominantly affects children and young adults. Early triage in the ED, recognition of severity signs, and prompt referral are critical to improving outcomes. These findings have direct implications for emergency medicine practice in resource-limited settings.