Acute poisoning surveillance in the emergency department: severity, intent, recurrence, and prevention endpoints

This letter comments on Özdal and Yüksel's one-year profile of 665 acute poisoning cases in a tertiary emergency department. The predominance of intentional poisoning, medication and alcohol exposure among intentional cases, carbon monoxide exposure among unintentional cases, and higher admission rates after intentional exposure indicate that poisoning epidemiology should move beyond descriptive exposure counts. We propose that future emergency toxicology datasets should integrate four linked domains: exposure characteristics, standardized clinical severity, intent-based psychosocial risk, and recurrence/prevention endpoints. Variables such as Poisoning Severity Score, estimated dose, co-ingestion, time from exposure to emergency department arrival, antidote use, electrocardiographic toxicity, organ injury, intensive care requirement, psychiatric consultation, discharge safety planning, 30-day revisit, and public health notification for environmental exposures may improve clinical interpretation and prevention value. Embedding this minimum dataset into routine electronic emergency department forms may support more comparable and actionable toxicovigilance in Türkiye and similar health systems.