{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:52:51Z","timestamp":1786121571755,"version":"build-2736575974"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"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":"\n Objective<\/jats:title>\n To identify independent risk factors for the progression of acute poisoning to severe cases in children, and to provide a basis for early clinical identification and intervention.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective study was conducted to collect the clinical data of hospitalized children with acute poisoning at Tianshui First People's Hospital from January 1, 2018 to December 31, 2025. According to the Poisoning Severity Score (PSS), patients were divided into the severe group (\u22653 points) and the non-severe group (&lt;3 points). Variables that were statistically significant in univariate analysis were included in binary logistic regression analysis to identify independent risk factors for severe poisoning.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 726 children with acute poisoning were enrolled, including 79 (10.9%) severe cases and 647 (89.1%) non-severe cases\n .<\/jats:bold>\n Two deaths occurred, with a case fatality rate of 0.3%. The difference across age groups was statistically significant (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200910.451,\n P<\/jats:italic>\n \u2009=\u20090.015), with adolescents accounting for the highest proportion of severe cases (48.1%, 38\/79). Multivariate logistic regression analysis revealed that gastric lavage was significantly associated with lower odds of severe poisoning (\n OR<\/jats:italic>\n \u2009=\u20090.355, 95%\n CI<\/jats:italic>\n : 0.157\u20130.800,\n P<\/jats:italic>\n \u2009=\u20090.013); antidote use was associated with an increased risk of severe poisoning (\n OR<\/jats:italic>\n \u2009=\u20093.156, 95%\n CI<\/jats:italic>\n : 1.933\u20135.152,\n P<\/jats:italic>\n \u2009&lt;\u20090.001), while left-behind children (\n OR<\/jats:italic>\n \u2009=\u20093.013, 95%\n CI<\/jats:italic>\n : 1.558\u20135.828,\n P<\/jats:italic>\n \u2009=\u20090.001) and self-poisoning (\n OR<\/jats:italic>\n \u2009=\u20092.113, 95%\n CI<\/jats:italic>\n : 1.283\u20133.481,\n P<\/jats:italic>\n \u2009=\u20090.003) were independent risk factors\n .<\/jats:bold>\n The ROC curve showed an area under the curve (AUC) of 0.710 (95% CI: 0.645\u20130.775).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Gastric lavage associated with a lower risk of severe poisoning in this pediatric cohort. When strictly indicated, it may remain a procedure of clinical value. Left-behind children and those with self-poisoning are high-risk populations requiring enhanced family supervision, early recognition, and psychological intervention. The association between antidote use and increased risk of severe poisoning likely reflects confounding by indication, and should not delay necessary antidotal therapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fped.2026.1903927","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T05:28:01Z","timestamp":1786080481000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of risk factors for severe acute poisoning in children"],"prefix":"10.3389","volume":"14","author":[{"given":"Jing","family":"Li","sequence":"first","affiliation":[{"name":"The First Clinical Medical College, Gansu University of Chinese Medicine","place":["Lanzhou, China"]},{"name":"Tianshui First People\u2019s Hospital","place":["Tianshui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei Kai","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College, Gansu University of Chinese Medicine","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.3760\/cma.j.cn114656-20250925-00682","article-title":"Expert consensus on the application of blood purification in acute poisoning","volume":"34","year":"2025","journal-title":"Chin J Emerg Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s40001-025-03633-w","article-title":"A clinical review of acute poisoning among pediatric individuals","volume":"31","author":"Zhang","year":"2025","journal-title":"Eur J Med Res"},{"key":"B3","volume-title":"China Health Statistics Yearbook 2023","year":"2024"},{"key":"B4","doi-asserted-by":"publisher","first-page":"81","DOI":"10.3760\/cma.j.issn.1673-4912.2018.02.001","article-title":"The current situation of acute poisoning in children","volume":"25","year":"2018","journal-title":"Chin J Pediatr Emerg Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1186\/s12873-024-01091-x","article-title":"Clinical characteristics and toxicological spectrum analysis of 493 cases of acute poisoning in children","volume":"24","author":"Xue","year":"2024","journal-title":"BMC Emerg Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"910","DOI":"10.3760\/cma.j.cn112140-20230328-00214","article-title":"Poisonous substances and geographical distribution of poisoning in hospitalized children based on data from 25 hospitals in China from 2016 to 2020","volume":"61","author":"Cai","year":"2023","journal-title":"Chin J Pediatr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.3760\/cma.j.issn.1671-0282.2016.11.004","article-title":"Chinese Expert consensus on diagnosis and treatment of acute poisoning","volume":"25","year":"2016","journal-title":"Chin J Emerg Med"},{"key":"B8","volume-title":"Internal Medicine","author":"Ge","year":"2024"},{"key":"B9","doi-asserted-by":"publisher","first-page":"205","DOI":"10.3109\/15563659809028940","article-title":"Poisoning severity score. 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