Severe acute poisoning among adolescents in Beijing: a 3-year retrospective cohort study at a tertiary referral center (2021–2023)

Purpose: This study aimed to characterize the epidemiological features, management, and outcomes of acute poisoning among adolescents in Beijing and surrounding areas to guide targeted prevention and clinical intervention. Methods: A retrospective cohort study was conducted among adolescents (aged 11-18 years) admitted for acute poisoning to the emergency or pediatric department of a tertiary toxicological referral center in Beijing between January 2021 and December 2023. Data on demographics, exposure characteristics, toxic agents, treatments, and clinical outcomes were collected and analyzed. Results: Among the 915 included cases, there was a significant female predominance (72.5%). Intentional self-harm accounted for the vast majority of incidents (94.5%), with oral ingestion being the primary route (99.5%). A high prevalence of preexisting psychiatric disorders was observed (60.1%). Pharmaceutical poisoning was the most common type (78.1%), followed by pesticides (12.5%). Common interventions included gastrointestinal decontamination (55.7%), extracorporeal elimination (22.3%), and antidote administration (3.1%). While most cases resulted in favorable outcomes (98.7%), adverse outcomes occurred in 1.3% of cases and were primarily associated with herbicide exposure. Logistic regression identified younger age, prehospital interventions, preexisting neuropsychiatric disorders, pesticide exposure, multi-agent mixed exposures, industrial chemical poisoning, and intentional self-harm as significant predictors of hospitalization. Conclusion: The findings underscore the critical importance of strengthening mental health support for adolescents and implementing stricter controls on the accessibility of psychotropic medications and highly toxic pesticides.