Chi Keung Chan

Background: The Hong Kong Poison Information Centre (HKPIC) has been providing consultation services to healthcare professionals and collecting epidemiological data on poisoning in Hong Kong since 2005. Objective: To analyse and report the poisoning data from HKPIC in 2022. Methods: A retrospective review was conducted on all poisoning cases recorded in the Poison Information and Clinical Management System of HKPIC in 2022. Results: A total of 3226 poisoning cases were analysed. There was a decrease of approximately 20% in total poisoning cases compared to 2021. Despite the decrease in the total poisoning caseload, there was an increase in the absolute number of poisoning‐related deaths by 14% (from 36 to 41) and cases with major outcomes by 31% (from 146 to 191), resulting in an increase in the case‐fatality rate from 1.0% in 2021 to 1.4% in 2022. More decontamination was performed and more antidotes were used in 2022 in comparison with the previous 5‐year average. Teenage (13–19 years) poisoning incidence continued to be high (16.3% of total poisoning cases). Additionally, four interesting cases and a few poisoning clusters were discussed. Conclusions: This 17th annual report provides valuable information on poisoning patterns in Hong Kong, highlighting the changes in local poisoning epidemiology during the third year of the COVID‐19 pandemic.

Background: Digoxin is a commonly used cardiovascular drug but has a narrow therapeutic window, and its poisoning could be fatal. Prognostic factors of digoxin poisoning were proposed largely based on the toxicokinetics of digoxin. Higher levels of evidence on this topic were limited. Objective: The study aimed to identify patient characteristics and risk factors associated with poor outcomes in acute or acute‐on‐chronic digoxin poisoning and to review the poor outcome rates, the time intervals between acute or acute‐on‐chronic digoxin poisoning and healthcare facility attendances, the overall mortality rate, and antidote usage of digoxin poisoning in Hong Kong. Methods: A retrospective cohort study was conducted using data from the Hong Kong Poison Information Centre from 1 January 2008 to 31 December 2022. Included were adult patients with acute or acute‐on‐chronic digoxin poisoning who presented to outpatient facilities. Excluded were individuals under 18 years, pregnant, had incomplete or unrelated medical records. Univariate and multivariable logistic regression analyses were used to identify predictors of poor outcomes. Results: During the study period, 57 adult cases of digoxin poisoning were identified for further analysis. Among these patients, 36 (63%) had good outcomes (no effect, minor effect, or moderate effect from the poisoning) while 21 (37%) had poor outcomes (major effect or death), and there were 8 (14%) deaths in total. Multivariable analysis and analysis of the receiver operating characteristic curve revealed that poor outcomes were significantly associated with an initial systolic blood pressure below 123.5 mmHg ( p = 0.034), an initial pulse rate below 59.5 beats per minute ( p = 0.009), and a serum potassium level above 4.64 mmol/L ( p = 0.018). Conclusions: In adult patients with acute or acute‐on‐chronic digoxin poisoning, the initial systolic blood pressure, pulse rate, and potassium levels are the most important predictors of poor outcomes upon initial presentation. These findings allow early recognition of patients with poor outcomes for further management.

Introduction: This study aimed to investigate the availability of pet spider species in Hong Kong and spider keeper's perception of the danger of exotic spiders. Method: This is a cross‐sectional questionnaire study targeting Hong Kong spider hobbyists that was conducted from June to December 2024. Electronic questionnaires were distributed to spider hobbyists using the snowball sampling method. Physical and online stores were sampled for the availability of spider species. Local cases of consults related to exotic spiders were examined. Results: 75 participants responded to the survey, and 74 of them had kept Theraphosidae (tarantulas). The top three popular breeds were Grammostola , Brachypelma , and Caribena . Around 20% of them had been bitten by spiders, and 40% of them had been disturbed by urticating hair. Around half of them perceived the bite and urticating hair as dangerous. For the online and physical store visits, five families of spiders and 29 genera of tarantulas were available for sale. Discussion: The majority of the participants kept tarantulas. Despite some participants having experienced health risks, half of the participants did not view the risks as significant, indicating a potential knowledge gap. The study had limitations, such as a small sample size and reliance on self‐reported data, but offered insights into the local spider‐keeping community. Conclusion: Despite keeping exotic spiders, mostly tarantulas, who could be potentially dangerous to health, only around half of the exotic spider keepers were equipped with the proper knowledge to perceive the potential dangers. Further education among this population might be required.