Citation

Savage M, Kung R, Green C, Thia B, Perera D, Tiruvoipati R. Australas. Psychiatry 2020; ePub(ePub): ePub.

Affiliation

Department of Intensive Care Medicine, Frankston Hospital (Peninsula Health), Australia; and Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia.

Copyright

(Copyright © 2020, Royal Australian and New Zealand College of Psychiatrists, Publisher SAGE Publishing)

DOI

10.1177/1039856219889317

PMID

31912753

Abstract

OBJECTIVE: To describe the characteristics of patients presenting to an Emergency Department (ED) following overdoses; to identify risk factors for intensive care unit (ICU) admission among these patients; and to identify the rate of mortality and repeat overdose presentations over four years.

METHODS: Adult patients presenting to ED following drug overdose during 2014 were included. Data were collected from medical notes and hospital databases.

RESULTS: During the study period, 654 patients presented to ED 800 times following overdose. Seventy-eight (9.8%) resulted in ICU admission, and 59 (7.4%) required intubation; 57.2% had no history of overdose presentations, and 72.9% involved patients with known psychiatric illness. Overdose of atypical antipsychotics (AAP), age and history of prior overdose independently predicted ICU admission. A third of patients (n = 196, 30%) had subsequent presentations to ED following overdose, in the four years from their index presentation, with an all-cause four-year mortality of 3.4% (n = 22).

CONCLUSION: A history of overdose, use of AAP and older age were risk factors for ICU admission following ED presentations. Over a third of patients had repeat overdose presentation in the four-year follow-up with a mortality of 3.4%.

Language: en

Keywords

emergency department; intensive care; overdose; poisoning; self-harm