Abstract
The UK has one of the highest rates of deliberate drug overdose in Europe but little is known about patients admitted to intensive care. We reviewed the epidemiology and outcome of patients with self-poisoning admitted to the intensive care unit (ICU) in a tertiary teaching hospital in Scotland and related this to previously established international patterns. All patients admitted to the ICU in the period 2005–2009 were reviewed to identify those with a diagnosis of drug overdose or self-poisoning. The records of these patients (n=481, 3.8%) were analysed to obtain details about epidemiology, investigation, organ support and outcome. Median age was 37 years and male: female ratio was 1.44:1. The substances most commonly involved were: alcohol (41%), tricyclic antidepressants (28%), benzodiazepines (21%), recreational drugs (23%), opioids (14%), and paracetamol (19%). The majority of patients (69%) required ventilatory support, 6% received inotropic support and 6% received renal replacement therapy. A CT brain scan was performed in 176 patients (37%): acute changes were found in six patients but these did not influence the acute management of any patient. Median length of stay in intensive care was 0.7 days and only 12% of patients remained in intensive care longer than 48 hours. Twenty patients (4%) died in hospital. The demography of patients admitted to intensive care after self-poisoning and the substances involved are changing, with increasing prevalence of alcohol, recreational drugs and opioids. This has significant implications for society and health care now and in the future.