TY - JOUR
T1 - Predictors of ICU admission and long-term outcomes in overdose presentations to Emergency Department
AU - Savage, Mark
AU - Kung, Ross
AU - Green, Cameron
AU - Thia, Brandon
AU - Perera, Dinushka
AU - Tiruvoipati, Ravindranath
PY - 2020/2
Y1 - 2020/2
N2 - 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%.
AB - 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%.
KW - emergency department
KW - intensive care
KW - overdose
KW - poisoning
KW - self-harm
UR - http://www.scopus.com/inward/record.url?scp=85077555638&partnerID=8YFLogxK
U2 - 10.1177/1039856219889317
DO - 10.1177/1039856219889317
M3 - Article
C2 - 31912753
AN - SCOPUS:85077555638
SN - 1039-8562
VL - 28
SP - 75
EP - 79
JO - Australasian Psychiatry
JF - Australasian Psychiatry
IS - 1
ER -