Skip to main content
Erschienen in: Irish Journal of Medical Science (1971 -) 3/2014

01.09.2014 | Original Article

Characteristics of patients admitted to the intensive care unit following self-poisoning and their impact on resource utilisation

verfasst von: A. McMahon, J. Brohan, M. Donnelly, G. J. Fitzpatrick

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Self-poisoning accounts for up to 10 % of hospital admissions, some of whom require admission to ICU. Few studies have looked at the epidemiology of these patients in an Irish setting.

Aims

To quantify the proportion of ICU admissions attributable to self-poisoning, to examine the characteristics and outcome of these patients, and to assess their ICU resource utilisation.

Methods

Retrospective review of ICU admissions from 2006 to 2010. Data were collected on patient age, sex, admission diagnosis, substances involved, APACHE II score, length of stay, organ support, and outcome.

Results

There were 80 admissions to ICU following self-poisoning accounting for 3.8 % of ICU admissions and 13 % of all hospital admissions for self-poisoning. M:F ratio was 0.9:1. Mean age 35 (range 16–75), APACHE II score 14 (2–36). Commonest substances involved were benzodiazepines, opioids, tricycle antidepressants. Median ICU stay was 2 days (IQR 0.96–4.5). 84 % of patients were ventilated, 27.5 % required inotropic support, 14 % renal replacement therapy. When opioids were involved requirement for inotropes and CRRT were higher. ICU mortality was 6.3 %. These patients consumed 280 bed days.

Conclusion

Self-poisoning accounted for 3.8 % of ICU admissions. Patients tend to require a short period of ventilation, with a minority requiring additional organ support. The cost of ICU care is calculated based on previously published methodology to be €7,717 per patient. Extrapolated nationally the annual cost for ICU care for self-poisoning is estimated to be in the order of €5 m.
Literatur
1.
Zurück zum Zitat Lai MW, Klein-Schwartz W, Rodgers GC et al (2005) Annual report of the american association of poison control centers national poisoning and exposure database. Clin Toxicol 44:803–932CrossRef Lai MW, Klein-Schwartz W, Rodgers GC et al (2005) Annual report of the american association of poison control centers national poisoning and exposure database. Clin Toxicol 44:803–932CrossRef
2.
Zurück zum Zitat Mokhlesi B, Leiken JB, Murray P et al (2003) Adult toxicology in critical care: part I: general approach to the intoxicated patient. Chest 123:577–592PubMedCrossRef Mokhlesi B, Leiken JB, Murray P et al (2003) Adult toxicology in critical care: part I: general approach to the intoxicated patient. Chest 123:577–592PubMedCrossRef
3.
Zurück zum Zitat Clark D, Murray DB, Ray D (2011) Epidemiology and outcomes of patients admitted to critical care after self-poisoning. J Intensiv Care Soc 12:268–273 Clark D, Murray DB, Ray D (2011) Epidemiology and outcomes of patients admitted to critical care after self-poisoning. J Intensiv Care Soc 12:268–273
4.
Zurück zum Zitat McLaughlin AM, Hardt J, Canavan J et al (2009) Determining the economic cost of ICU treatment: a prospective “micro-costing” study. Intensiv Care Med 35:2135–2140CrossRef McLaughlin AM, Hardt J, Canavan J et al (2009) Determining the economic cost of ICU treatment: a prospective “micro-costing” study. Intensiv Care Med 35:2135–2140CrossRef
5.
Zurück zum Zitat Nelson M, Mongan D (2010) Non-fatal overdoses and drug related admissions, Drugnet Ireland, alcohol and drug research newsletter 34. Health Research Board, Dublin Nelson M, Mongan D (2010) Non-fatal overdoses and drug related admissions, Drugnet Ireland, alcohol and drug research newsletter 34. Health Research Board, Dublin
6.
Zurück zum Zitat Schwake L, Wollenschlager I, Stremmel W et al (2009) Adverse drug reactions and deliberate self-poisoning as a cause of admission to the intensive care unit: a 1 year prospective observational cohort study. Intensiv Care Med 35:266–274CrossRef Schwake L, Wollenschlager I, Stremmel W et al (2009) Adverse drug reactions and deliberate self-poisoning as a cause of admission to the intensive care unit: a 1 year prospective observational cohort study. Intensiv Care Med 35:266–274CrossRef
7.
Zurück zum Zitat Liisanantti JH, Ohtonen P, Kiviniemi O et al (2011) Risk factors for prolonged intensive care stay and hospital mortality in acute drug-poisoned patients: an evaluation of the physiologic and laboratory parameters on admission. J Crit Care 26:160–165PubMedCrossRef Liisanantti JH, Ohtonen P, Kiviniemi O et al (2011) Risk factors for prolonged intensive care stay and hospital mortality in acute drug-poisoned patients: an evaluation of the physiologic and laboratory parameters on admission. J Crit Care 26:160–165PubMedCrossRef
8.
Zurück zum Zitat O’Donovan FC, Owens J, Tracey JA (1993) Self-poisoning: admission to intensive care over a 1 year period. Ir Med J 86:64–65PubMed O’Donovan FC, Owens J, Tracey JA (1993) Self-poisoning: admission to intensive care over a 1 year period. Ir Med J 86:64–65PubMed
9.
Zurück zum Zitat O’Brien BP, Murphy D, Conrick-Martin I et al (2009) The functional outcome and recovery of patients admitted to an intensive care unit following drug overdose: a follow-up study. Anaesth Intensiv Care 37:802–806 O’Brien BP, Murphy D, Conrick-Martin I et al (2009) The functional outcome and recovery of patients admitted to an intensive care unit following drug overdose: a follow-up study. Anaesth Intensiv Care 37:802–806
11.
Zurück zum Zitat National Casemix Programme (2013) Ready reckoner of acute hospital inpatient and daycase activity and costs (summarised by DRG) relating to 2011 costs and activity. Ireland, Health Service Executive National Casemix Programme (2013) Ready reckoner of acute hospital inpatient and daycase activity and costs (summarised by DRG) relating to 2011 costs and activity. Ireland, Health Service Executive
12.
Zurück zum Zitat Mc Laughlin AM, Hardt J, Mc Kay AP et al (2009) Alcohol, drug misuse and suicide attempts: unrecognised causes of out of hospital cardiac arrests admitted to intensive care units. Ir J Med Sci 178:29–33CrossRef Mc Laughlin AM, Hardt J, Mc Kay AP et al (2009) Alcohol, drug misuse and suicide attempts: unrecognised causes of out of hospital cardiac arrests admitted to intensive care units. Ir J Med Sci 178:29–33CrossRef
13.
Zurück zum Zitat Strøm J, Thisted B, Krantz T et al (1986) Self poisoning treated in an ICU: drug pattern, acute mortality and short-term survival. Acta Anaesthesiol Scand 30:148–153PubMedCrossRef Strøm J, Thisted B, Krantz T et al (1986) Self poisoning treated in an ICU: drug pattern, acute mortality and short-term survival. Acta Anaesthesiol Scand 30:148–153PubMedCrossRef
Metadaten
Titel
Characteristics of patients admitted to the intensive care unit following self-poisoning and their impact on resource utilisation
verfasst von
A. McMahon
J. Brohan
M. Donnelly
G. J. Fitzpatrick
Publikationsdatum
01.09.2014
Verlag
Springer London
Erschienen in
Irish Journal of Medical Science (1971 -) / Ausgabe 3/2014
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-013-1026-7

Weitere Artikel der Ausgabe 3/2014

Irish Journal of Medical Science (1971 -) 3/2014 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.