{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:19:14Z","timestamp":1783491554587,"version":"3.55.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute poisoning is a major pediatric emergency department (ED) presentation, yet evidence-based tools for early risk stratification at triage remain limited. This study aimed to characterize epidemiological trends and identify independent risk factors for clinically significant poisoning (Poisoning Severity Score [PSS]\u2009\u2265\u20092) in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of 2,345 children (&amp;lt;18 years) with acute poisoning (2021\u20132024). Patients were stratified into mild (PSS 0\u20131) and clinically significant (moderate-to-severe) groups. Multiple imputation handled missing data. Multivariable logistic regression identified independent risk factors. Model discrimination and calibration were assessed using the Area Under the Receiver Operating Characteristic curve (AUC-ROC) and Hosmer-Lemeshow test. Patient-centered outcomes (acute organ dysfunctions) were systematically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over 4 years, the poisoning spectrum shifted from agricultural chemicals toward psychotropic drugs (18.5%\u201331.2%). Clinically significant poisoning occurred in 422 patients (18.0%). Independent risk factors for moderate-to-severe outcomes were: age &amp;gt;12 years (aOR 2.34), intentional self-harm (aOR 3.12), pre-hospital delay &amp;gt;6\u2005h (aOR 2.78), multiple-agent exposure (aOR 2.15), exposure to agricultural herbicides (aOR 5.45), and psychotropic drugs (aOR 3.86). The model achieved an outstanding AUC-ROC of 0.892 (95% CI: 0.864\u20130.920). Clinically significant poisoning (PSS\u2009\u2265\u20092) was strongly associated with patient-centered organ injury, including acute respiratory failure (26.5% vs. 0.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), toxic encephalopathy (22.5% vs. 0.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and Multiple Organ Dysfunction Syndrome (MODS, 12.8% vs. 0.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) compared to mild cases. These cases required PICU admission (71.1%) and blood purification (44.1%) significantly more often. Mortality was 1.2% (28\/2,345), occurring exclusively in the PSS\u2009\u2265\u20092 group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Readily identifiable risk factors\u2014age &amp;gt;12 years, self-harm, delay &amp;gt;6\u2005h, multiple-agent exposure, and exposure to herbicides or psychotropics\u2014independently predict clinically significant pediatric poisoning. The PSS\u2009\u2265\u20092 classification correlates tightly with acute organ dysfunction and Multiple Organ Dysfunction Syndrome (MODS).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1881926","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:59:00Z","timestamp":1783490340000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Independent risk factors for clinically significant acute poisoning in children presenting to the emergency department: a 4-year cohort study of 2,345 cases"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhai","family":"Zhao","sequence":"first","affiliation":[{"name":"Emergency Department, Children's Hospital of Hebei Province, Hebei Clinical Research Center for Children's Health and Diseases","place":["Shijiazhuang City, 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjin","family":"Geng","sequence":"additional","affiliation":[{"name":"Emergency Department, Children's Hospital of Hebei Province, Hebei Clinical Research Center for Children's Health and Diseases","place":["Shijiazhuang City, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1235304","DOI":"10.3389\/fpubh.2023.1235304","article-title":"Trends and profiles of acute poisoning cases: a retrospective analysis","volume":"11","author":"Liu","year":"2023","journal-title":"Front Public Health"},{"key":"B2","year":"2022"},{"key":"B3","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/S2352-4642(18)30095-6","article-title":"Causes of death among children aged 5\u201314 years in the WHO European region: a systematic analysis for the global burden of disease study 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