Acute Drug Overdose: Clinical Profile, Etiologic Spectrum and Determinants of Duration of Intensive Medical Treatment

Abstract

Early and prompt intensive medical therapy in acute drug poisoning can favorably influence the outcome. In addition, the presence of hypotension and requirement of mechanical ventilation on the first two days of hospitalization were responsible for prolonged ICU stay.

Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU

“…Our toxicology results are proportionate to formerly published data [5,6,13]. Including methadone, opiates was the most common substance detected in the urine toxicology screen of our subjects (30, 55%).…”

“…Even though the rate of mechanical ventilation reported in our study is significantly higher than in other similar publications [5,13,20,21,24–26], our ICU LOS is comparable to other related series [13,16,26]. As previously outlined in other reports, mechanical ventilation was most frequently required in patients with opiates intoxication [27,28].…”

“…To our knowledge, this is the first study conducted in NYC addressing the utilization of ICU resources among patients with acute drug poisoning admitted to critical care units. The proportion of patients admitted to ICU in our study was substantially higher than previously reported in the literature [5,6,13–16,18–21], probably as a result of the hospital geographic location and our patients’ socio-demographic characteristics. Despite the fact that our data is exclusively limited to results obtained from admissions during the autumn and winter, other related publications also showed a peak of ICU admissions during these seasons [21–23].…”

“…The unadjusted ICU mortality in our cohort was significantly higher than previously reported in other similar studies [5,6,13,16,18,20,24,26]. These patients were older, had higher SOFA scores on admission, and opiates were the most commonly detected substance in their toxicology screen.…”

“…From 1999 to 2008, hospitalization rates for overdose in USA increased by 55%, costing about US$737 million in 2008 [10]. Patients with acute drug intoxication represent 0.6–2.1% of all ED visits [11,12], and account for 3–14% of total Intensive Care Unit (ICU) admissions [13–16]. In the Western hemisphere, both ICU and in-hospital mortality of patients with acute drug intoxication are significantly lower than that of the general ICU population, at 0.2–4% [16,17].…”