Citation

McMahon AD, Brohan J, Donnelly M, Fitzpatrick GJ. Ir. J. Med. Sci. 2013; 183(3): 391-395.

Affiliation

Department of Anaesthesia Critical Care and Pain Medicine, The Adelaide and Meath Hospital Dublin, Incorporating the National Childrens Hospital, Tallaght, Dublin 24, Ireland.

Copyright

(Copyright © 2013, General Publications)

DOI

10.1007/s11845-013-1026-7

PMID

24101144

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.

Language: en