Citation:Jeevan Dhanarisi, Sriyani Perera, Thilini Wijerathna, Indika Gawarammana, Fathima Shihana, Vindya Pathiraja, Michael Eddleston, Fahim Mohamed, Relationship Between Alcohol Co-Ingestion and Clinical Outcome in Pesticide Self-Poisoning: A Systematic Review and Meta-Analysis, Alcohol and Alcoholism, Volume 58, Issue 1, January 2023, Pages 4–12, https://doi.org/10.1093/alcalc/agac045
Date:2022-09-28
Abstract:
Aim. Alcohol is a commonly co-ingested compound during self-poisoning with pesticides. Clinical experiences suggest alcohol co-ingestion
(or withdrawal) makes patient management more difficult after self-poisoning and may contribute to poor clinical outcomes. We aimed to
systematically review the world literature to explore the relationship between alcohol co-ingestion and outcome in pesticide self-poisoning.
Methods. We searched 13 electronic databases and Google scholar, conducted citation searching and a review of reference lists to find studies
which investigated the relationship of alcohol with clinical outcome of pesticide self-poisoning in different countries. Thirteen studies, including
11 case series/reports and two cohort studies were considered for inclusion.
Results. Meta-analysis showed that alcohol co-ingestion in pesticide self-poisoning was associated with increased risk of death [odds ratio
(OR) 4.9, 95% confidence interval (CI) 2.9–8.2 P<0.0001] and that alcohol co-ingested group required intubation eight times more often than
non-co-ingested group in organophosphorus insecticide self-poisoning (OR 8.0, 95% CI 4.9–13.0 P<0.0001). Cases who co-ingested alcohol
were older than non-alcohol group in two studies. One cohort study demonstrated that alcohol co-ingestion was associated with larger pesticide
ingestions but did not itself affect the outcome.
Conclusions. This systematic review indicates that alcohol co-ingestion may worsen clinical outcome in pesticide self-poisoning.
