Öz

Aims: Intentional drug overdose is a leading cause of poisoning-related intensive care admissions and a major concern in clinical toxicology and public health. Identifying toxicological patterns, demographic features, and associated outcomes is essential to guide prevention and optimize early management.

Methods: We conducted a retrospective analysis of toxicological profiles, psychiatric history, and clinical outcomes among patients admitted to the intensive care unit after intentional drug overdose. Data collected included demographics, psychiatric comorbidities, ingested drug classes, length of stay in the intensive care unit, need for mechanical ventilation, and mortality. Patients were categorized as single- or multiple-drug ingestion, and groups were compared using appropriate statistical tests.

Results: Among 229 patients (57.2% female; 59.1% aged 18–33 years), antidepressants (20.9%) and analgesics (17.3%) were the most frequent agents. Multiple-drug ingestion occurred in 65.9% and was associated with a longer intensive care unit stay (2.31 ± 2.61 vs. 1.60 ± 0.83 days; P = 0.0088). Mechanical ventilation was required in 3.1%, and mortality was 0.3%.

Conclusion: Intentional overdose predominantly affects young adults and often involves multiple-drug ingestion (acute polypharmacy). Although critical outcomes were rare, polypharmacy correlated with prolonged intensive care unit stay, supporting prevention efforts and targeted psychiatric follow-up.

Anahtar Kelimeler: drug overdose, poisoning, intensive care units, length of stay, respiration, artificial, suicide, attempted

Referanslar

  1. Patel MM, Travers CD, Stockwell JA, Geller RJ, Kamat PP, Grunwell JR. Analysis of interventions required in 12,021 children with acute intoxications admitted to PICUs. Pediatr Crit Care Med. 2017;18:e281-9. https://doi.org/10.1097/PCC.0000000000001187
  2. Kawashima Y, Yonemoto N, Inagaki M, Yamada M. Prevalence of suicide attempters in emergency departments in Japan: a systematic review and meta-analysis. J Affect Disord. 2014;163:33-9. https://doi.org/10.1016/j.jad.2014.03.025
  3. Thanacoody R, Anderson M. Epidemiology of poisoning. Medicine (Baltimore). 2020;48:153-5. https://doi.org/10.1016/j.mpmed.2019.12.001
  4. Heyerdahl F, Bjornas MA, Hovda KE, et al. Acute poisonings treated in hospitals in Oslo: a one-year prospective study (II): clinical outcome. Clin Toxicol (Phila). 2008;46:42-9. https://doi.org/10.1080/15563650701210048
  5. Peñuelas O, Frutos-Vivar F, Fernández C, et al. Characteristics and outcomes of ventilated patients according to time to liberation from mechanical ventilation. Am J Respir Crit Care Med. 2011;184:430-7. https://doi.org/10.1164/rccm.201011-1887OC
  6. Gilbert EH, Lowenstein SR, Koziol-McLain J, Barta DC, Steiner J. Chart reviews in emergency medicine research: where are the methods? Ann Emerg Med. 1996;27:305-8. https://doi.org/10.1016/s0196-0644(96)70264-0
  7. Miniksar ÖH, Yıldız Miniksar D. Retrospective evaluation of adolescent drug intoxications followed in the intensive care unit. J Health Sci Med. 2020;3:203-8. [ https://doi.org/10.32322/jhsm.665105
  8. Tüfek D, Taşdemir BB, Sıvacı R. Retrospective investigation of intoxication cases followed up in intensive care unit. Turk J Intensive Care. 2017;15:67-71. https://doi.org/10.4274/tybdd.42243
  9. Muhammedoğlu N, Başaranoğlu G, Gül YG, Toptaş M, Baltalı S, Özütürk B. Evaluation of suicide and intoxication cases admitted to our newly opened intensive care unit. Medical Bulletin of Haseki. 2014;52:153-7. https://doi.org/10.4274/haseki.1766
  10. Lee HL, Lin HJ, Yeh STY, Chi CH, Guo HR. Presentations of patients of poisoning and predictors of poisoning-related fatality: findings from a hospital-based prospective study. BMC Public Health. 2008;8:7. https://doi.org/10.1186/1471-2458-8-7
  11. Sorge M, Weidhase L, Bernhard M, Gries A, Petros S. Self-poisoning in the acute care medicine 2005-2012. Anaesthesist. 2015;64:456-62. https://doi.org/10.1007/s00101-015-0030-x
  12. Dündar M, Mammadova N, Akyildiz BN. Demographic and clinical analysis of pediatric poisoning in intensive care. Annals of Medical Research. 2024;31:799-804. https://doi.org/10.5455/annalsmedres.2024.08.163
  13. Kim SH, Kim HJ, Oh SH, Cha K. Analysis of attempted suicide episodes presenting to the emergency department: comparison of young, middle aged and older people. Int J Ment Health Syst. 2020;14:46. https://doi.org/10.1186/s13033-020-00378-3
  14. Erol MK, Karahan MA, Altay N, Büyükfırat E. Retrospective analysis of cases diagnosed with acute poisoning due to antidepressant drug use in intensive care unit. Journal of Harran University Medical Faculty. 2018;15:226-9.
  15. Yeşiler Fİ, Şendur ÜG, İnan Demiroğlu G. Analysis of acute intoxication cases in intensive care unit. Aegean Journal of Medical Sciences. 2019;2:14-8. https://doi.org/10.33713/egetbd.472719
  16. Totoz T, Türk HŞ, Sayın P, Çınar S, Yıldırım Ç, Oba S. Retrospective analysis of intoxicated patients in our intensive care unit. Sisli Etfal Hastan Tip Bul. 2013;47:63-6. https://doi.org/10.5350/SEMB2013470204
  17. Wilcox HC, Conner KR, Caine ED. Association of alcohol and drug use disorders and completed suicide: an empirical review of cohort studies. Drug Alcohol Depend. 2004;76 Suppl:S11-9. https://doi.org/10.1016/j.drugalcdep.2004.08.003
  18. Ilgen MA, Harris AHS, Moos RH, Tiet QQ. Predictors of a suicide attempt one year after entry into substance use disorder treatment. Alcohol Clin Exp Res. 2007;31:635-42. https://doi.org/10.1111/j.1530-0277.2007.00348.x
  19. Stanley B, Brown GK, Brenner LA, et al. Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA Psychiatry. 2018;75:894-900. https://doi.org/10.1001/jamapsychiatry.2018.1776
  20. Turkish Statistical Institute. Ölüm ve ölüm nedeni istatistikleri, 2023. Available at: https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2023-53709 (Accessed on Jun 4, 2025).
  21. Yılmaz Y, İnal FY, Toptaş M, Gürelik B, Erşan İ. Retrospective evaluation of intoxication cases presented to Sivas Numune Hospital. Medical Bulletin of Haseki. 2013;51(4):178-82. https://doi.org/10.4274/Haseki.1247
  22. Calcaterra SL, Severtson SG, Bau GE, et al. Trends in intentional abuse or misuse of benzodiazepines and opioid analgesics and the associated mortality reported to poison centers across the United States from 2000 to 2014. Clin Toxicol (Phila). 2018;56:1107-14. https://doi.org/10.1080/15563650.2018.1457792
  23. Khalid MM, Waseem M. Tricyclic antidepressant toxicity. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available at: http://www.ncbi.nlm.nih.gov/books/NBK430931 (Accessed on Jun 4, 2025).

Nasıl atıf yapılır?

1.
Şenol Karataş S, Bulut OK, Öner SF. Intentional drug overdose in the intensive care unit: A three-year retrospective cohort on polypharmacy and length of stay. Turk J Intensive Care. 2026;24(2):124-133. https://doi.org/10.63729/TJIC.2026.693