Clinical characteristics, associated factors, and management of pediatric poisoning in a tertiary pediatric intensive care unit: a 14-year retrospective study

Background This study aimed to characterize the demographic, clinical, exposure, and management patterns of pediatric poisoning, identify factors associated with intentional self-poisoning, assess severe clinical outcomes including organ failure and mortality, and evaluate factors associated with the treatment escalation requirement. Methods We retrospectively reviewed the records of all pediatric poisoning cases admitted to the PICU of Çukurova University Faculty of Medicine between January 1, 2011, and December 31, 2024. Demographic data, exposure characteristics, clinical findings, treatments, severity scores, organ failure, and mortality were analyzed. Separate multivariable logistic regression models were used to identify factors independently associated with intentional self-poisoning, organ failure, and treatment escalation requirement. Results A total of 450 patients were included; 60.4% were female. Most exposures occurred at home (96.9%) and via oral ingestion (99.3%). Accidental poisoning accounted for 57.1% of cases, whereas 42.9% involved suicide attempts. Central nervous system drugs were the most frequently implicated agents. Organ failure developed in 7.6%, and mortality was 0.9%. Increasing age (adjusted odds ratio [aOR] 2.00) and female sex (aOR 3.56) were independently associated with suicide attempt. Electrocardiographic abnormalities (aOR 4.43) and cardiovascular drug poisoning (aOR 5.48) were associated with organ failure. Treatment escalation requirement was independently associated with suicide attempt (aOR 1.66), presentation more than one hour after exposure (aOR 1.73), and organophosphate poisoning (aOR 2.74). Conclusions Pediatric poisonings showed distinct age-related patterns. The observed associations support early risk assessment, close cardiac monitoring, and targeted management in higher-risk patients, together with age-specific preventive strategies addressing household safety in younger children and mental health vulnerability in adolescents. Causal effects of treatment timing or management strategies on clinical outcomes cannot be inferred from this retrospective study. Clinical trial number Not applicable.