Frontiers in medicine · 2026
Clinical characteristics and predictors of prolonged hospitalization in patients with cosmetic botulinum toxin poisoning: a retrospective cohort study.
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Chen Yu-Quan, Ye Yi-Fan, Xie Mei-Wen, Lin Yu-Qiang, Yang Zhi-Qian, Wang Zhi
Аннотация
BACKGROUND: The increasing cosmetic use of botulinum toxin has been accompanied by poisoning events related to inappropriate administration, including excessive dosing, unapproved or unverifiable products, self-injection, and procedures performed outside regulated medical settings. However, the inpatient clinical profile and predictors of prolonged hospitalization remain insufficiently defined. This study aimed to describe the clinical characteristics of cosmetic botulinum toxin poisoning and identify factors associated with longer hospital stay.
METHODS: We conducted a retrospective cohort study of patients hospitalized for cosmetic botulinum toxin poisoning at Guangzhou Twelfth People's Hospital between August 2024 and January 2025. Demographic data, injection-related characteristics, clinical manifestations, antitoxin treatment, hospitalization duration, and available clinical outcomes were extracted from medical records. Patients were divided into a short-stay group (<7 days) and a prolonged-stay group (≥7 days). Univariate analyses and multivariable Cox regression were performed to identify factors associated with hospitalization duration. A nomogram was developed to estimate length of stay.
RESULTS: A total of 145 patients were included, with a median age of 37 years; 97.93% were female. The most common injection sites were the forehead (26.35%), periocular region (16.77%), and jaw (11.98%). The most frequent manifestations were dizziness (89.66%), dysphagia (85.52%), blurred vision (75.17%), ptosis (68.28%), and slurred speech (24.83%). In multivariable Cox regression, duration of antitoxin therapy, dysphagia, and slurred speech were independently associated with prolonged hospitalization. A nomogram based on these variables showed acceptable calibration performance (MSE = 1.302; MAE = 1.029). No in-hospital deaths occurred.
CONCLUSION: Cosmetic botulinum toxin poisoning is characterized mainly by cranial nerve-related and bulbar manifestations. Dysphagia, slurred speech, and antitoxin treatment duration were independently associated with prolonged hospitalization. The nomogram may support early risk stratification and inpatient management, although external validation is needed.
METHODS: We conducted a retrospective cohort study of patients hospitalized for cosmetic botulinum toxin poisoning at Guangzhou Twelfth People's Hospital between August 2024 and January 2025. Demographic data, injection-related characteristics, clinical manifestations, antitoxin treatment, hospitalization duration, and available clinical outcomes were extracted from medical records. Patients were divided into a short-stay group (<7 days) and a prolonged-stay group (≥7 days). Univariate analyses and multivariable Cox regression were performed to identify factors associated with hospitalization duration. A nomogram was developed to estimate length of stay.
RESULTS: A total of 145 patients were included, with a median age of 37 years; 97.93% were female. The most common injection sites were the forehead (26.35%), periocular region (16.77%), and jaw (11.98%). The most frequent manifestations were dizziness (89.66%), dysphagia (85.52%), blurred vision (75.17%), ptosis (68.28%), and slurred speech (24.83%). In multivariable Cox regression, duration of antitoxin therapy, dysphagia, and slurred speech were independently associated with prolonged hospitalization. A nomogram based on these variables showed acceptable calibration performance (MSE = 1.302; MAE = 1.029). No in-hospital deaths occurred.
CONCLUSION: Cosmetic botulinum toxin poisoning is characterized mainly by cranial nerve-related and bulbar manifestations. Dysphagia, slurred speech, and antitoxin treatment duration were independently associated with prolonged hospitalization. The nomogram may support early risk stratification and inpatient management, although external validation is needed.