Acute drug overdose

Clinical profile, etiologic spectrum and determinants of duration of intensive medical treatment

B. Jayakrishnan, Abdullah Al Asmi, Ahmed Al Qassabi, R. Nandhagopal, Irshad Mohammed

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: Acute drug overdosing is an important cause of organ dysfunction and metabolic derangements and the patients often require intensive care. This study aims to determine the clinical pattern of severe drug overdose as well as the factors influencing the duration of intensive care Methods: The clinical characteristics and course of consecutive adult patients admitted with a diagnosis of acute drug poisoning in the ICU of a tertiary hospital in Oman from January 2007 to December 2008 were reviewed retrospectively from the electronic case records. Results: Acute drug poisoning (n=29) constituted 3.9% of admissions to the ICU. Mean age was 29.38±7.9 years. They were brought in by their relatives (72%) or the state services (24%). Accidental poisoning was noted in 21 patients (72%) and suicidal overdosing in 6 (21%). The commonest drug was an opioid (65.5%). Glasgow Coma Scale score of ≤8 was recorded in 18 (62.1%). Sixty two percent of patients required mechanical ventilation. The prominent complications were hypotension in 9 (31%), pulmonary in 19 (65.5%), hepatic in 18 (62.1%) and renal in 12 (41.4%) patients. The major electrolytes abnormalities were low bicarbonate in 11 (37.9%), hyponatremia in 5 (17.2%) and hypokalemia in 4 (13.8%). Patients stayed in the ICU for 1 to 20 days (median-2 days). Factors associated with a longer ICU stay included hypotension upon arrival (p=0.048) and the need for mechanical ventilation on the first (p=0.001) and second (p=0.001) days of hospitalization. There was no mortality. Conclusion: 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.

Original languageEnglish
Pages (from-to)501-504
Number of pages4
JournalOman Medical Journal
Volume27
Issue number6
DOIs
Publication statusPublished - 2012

Fingerprint

Drug Overdose
Poisoning
Artificial Respiration
Hypotension
Pharmaceutical Preparations
Critical Care
Hospitalization
Therapeutics
Oman
Glasgow Coma Scale
Hypokalemia
Hyponatremia
Bicarbonates
Tertiary Care Centers
Opioid Analgesics
Electrolytes
Kidney
Lung
Mortality
Liver

Keywords

  • Drug overdose
  • Intensive care
  • Oman
  • Opiates

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Acute drug overdose : Clinical profile, etiologic spectrum and determinants of duration of intensive medical treatment. / Jayakrishnan, B.; Al Asmi, Abdullah; Al Qassabi, Ahmed; Nandhagopal, R.; Mohammed, Irshad.

In: Oman Medical Journal, Vol. 27, No. 6, 2012, p. 501-504.

Research output: Contribution to journalArticle

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abstract = "Objectives: Acute drug overdosing is an important cause of organ dysfunction and metabolic derangements and the patients often require intensive care. This study aims to determine the clinical pattern of severe drug overdose as well as the factors influencing the duration of intensive care Methods: The clinical characteristics and course of consecutive adult patients admitted with a diagnosis of acute drug poisoning in the ICU of a tertiary hospital in Oman from January 2007 to December 2008 were reviewed retrospectively from the electronic case records. Results: Acute drug poisoning (n=29) constituted 3.9{\%} of admissions to the ICU. Mean age was 29.38±7.9 years. They were brought in by their relatives (72{\%}) or the state services (24{\%}). Accidental poisoning was noted in 21 patients (72{\%}) and suicidal overdosing in 6 (21{\%}). The commonest drug was an opioid (65.5{\%}). Glasgow Coma Scale score of ≤8 was recorded in 18 (62.1{\%}). Sixty two percent of patients required mechanical ventilation. The prominent complications were hypotension in 9 (31{\%}), pulmonary in 19 (65.5{\%}), hepatic in 18 (62.1{\%}) and renal in 12 (41.4{\%}) patients. The major electrolytes abnormalities were low bicarbonate in 11 (37.9{\%}), hyponatremia in 5 (17.2{\%}) and hypokalemia in 4 (13.8{\%}). Patients stayed in the ICU for 1 to 20 days (median-2 days). Factors associated with a longer ICU stay included hypotension upon arrival (p=0.048) and the need for mechanical ventilation on the first (p=0.001) and second (p=0.001) days of hospitalization. There was no mortality. Conclusion: 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.",
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