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SHR Neuro Cancer Cardio Lipid Metab Microb
Reisinger, AC; Schneider, N; Schreiber, N; Janisch, M; Rauch, I; Kaufmann, P; Wünsch, G; Eller, P; Hackl, G.
Critical care management of acute intoxications, dynamics and changes over time: a cohort study.
Intern Emerg Med. 2024; 19(7):2015-2024
Doi: 10.1007/s11739-024-03570-2
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- Leading authors Med Uni Graz
- Eller Philipp
- Reisinger Alexander Christian
- Schneider Nikolaus
- Co-authors Med Uni Graz
- Hackl Gerald
- Schreiber Nikolaus
- Wünsch Gerit
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- Abstract:
- Acute intoxications and poisonings are a relevant cause for ICU admission of critically ill patients. This study aimed to determine the characteristics of intoxicated patients in a tertiary center medical ICU in Austria over time and to investigate parameters associated with ICU mortality. This study was a retrospective data analysis including adult ICU patients from the years 2007 to 2021. In addition to ICU documentation, pre-hospital, and emergency department documents as well as autopsy reports were utilized. In an exploratory subanalysis, we compared these findings to a historical dataset from our facility from 1992 to 1996. We identified 581 cases admitted to the medical ICU because of acute poisoning (2007-2021), of which 45% were female and 46.6% were mixed intoxications. Suicidal intent was the primary cause of intoxication (48.2%) and ICU length of stay was median 1.2 days. The majority of deceased patients received pre-hospital mechanical CPR. Primary and secondary poison/toxin removal modalities were used in 29.9% and 11.7% of cases, whereas antidotes were administered in 54.4%. Comparing the data with a historical cohort (n = 168), we found a shift in primary detoxification away from gastric lavage and an increase in alternative secondary poison/toxin removal techniques. The ICU mortality was 4.1% and 4.2% in the present and historic cohort, respectively. Pre-existing psychiatric illnesses increased from 49% in the historic to 69% in the present cohort. Psychiatric illness predisposes patients to severe intoxications necessitating ICU care, thus increasing prevention measures seems warranted. Females did present with a different spectrum of intoxications compared to males. ICU mortality remained low over time and most deceased patients had a grim prognosis already on ICU arrival.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Female - administration & dosage
- Male - administration & dosage
- Retrospective Studies - administration & dosage
- Middle Aged - administration & dosage
- Poisoning - therapy, epidemiology
- Critical Care - statistics & numerical data, methods
- Adult - administration & dosage
- Aged - administration & dosage
- Austria - epidemiology
- Intensive Care Units - statistics & numerical data
- Cohort Studies - administration & dosage
- Hospital Mortality - administration & dosage
- Find related publications in this database (Keywords)
- Poisoning
- Intoxication
- Drugs
- Coma
- Toxin
- Extracorporeal