Document Type : Original Article
Authors
1
Senior Resident, Department of Forensic Medicine and Toxicology, A.I.I.M.S., Rishikesh, Uttarakhand, India
2
Professor and Head, Department of Forensic Medicine and Toxicology, A.I.I.M.S, Bhubaneswar, Odisha, India
3
Associate Professor, Department of Forensic Medicine and Toxicology, A.I.I.M.S., Bhubaneswar, Odisha, India
4
Associate Professor, Department of Trauma and Emergency Medicine, A.I.I.M.S., Bhubaneswar, Odisha, India
10.22038/apjmt.2026.93956.1554
Abstract
Background:: Acute poisoning is a major cause of preventable morbidity and mortality. In India, plant poisoning accounts for 6-15% of poisoning cases, with yellow oleander (Thevetia peruviana) among the most common toxic plants. Despite its clinical importance, evidence regarding severity assessment and prognostic factors remains limited. The Poisoning Severity Score (PSS) is an internationally accepted tool for grading poisoning severity, but it has rarely been evaluated for Yellow Oleander Poisoning (YOP) in India.
Methods: This prospective observational study assessed a modified Poisoning Severity Score in patients with YOP and evaluated its association with clinical outcomes. The modified PSS was recorded at admission, and patients were classified into grades 0-4 based on the most severe clinical signs and symptoms. Patients were followed until discharge or death.
Results: YOP accounted for 8.68% of all poisoning cases during the study period, with a case fatality proportion of 5.7%. Among 53 patients, the mean age was 30 years, and 64.2% were female. Most poisonings were intentional (88.7%), and ingestion of crushed seeds was the commonest mode of exposure (49.0%). Moderate poisoning (PSS Grade 2) was observed in 49.1% of patients. PSS grade showed significant associations with age, quantity of poison ingested, serum potassium level, duration of hospitalisation, and clinical outcome (all p<0.05). Overall, 88.7% of patients recovered, whereas all deaths occurred among patients with higher PSS grades.
Conclusion: The modified PSS is a useful tool for early assessment of severity and prognostication in Yellow Oleander Poisoning, supporting timely risk stratification and appropriate clinical management.
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