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Long-term outcomes after severe drug overdose.
Lee Y Wong1, Rinaldo Bellomo2, Ray Robbins3
1Department of Emergency Medicine, Austin Hospital, Melbourne, VIC, Australia. Leeyung.wong@austin.org.au.
Summary
Patients with drug overdose admitted to intensive care units (ICU) and general wards have similar long-term outcomes, including high rates of self-harm and poor quality of life. Mortality after discharge was 10% for ICU patients over 4 years.
Area of Science:
- Medical Research
- Clinical Outcomes
- Public Health
Background:
- Long-term outcomes for drug overdose patients vary based on initial hospital admission location (ICU vs. general ward).
- Previous studies have not adequately compared these patient groups regarding overdose recurrence, mortality, and quality of life.
Purpose of the Study:
- To compare long-term outcomes, including overdose recurrence, post-discharge mortality, cause of death, and quality of life (using EQ-5D), between drug overdose patients admitted to the ICU and general wards.
Main Methods:
- A retrospective cohort study included 102 ICU and 102 matched general ward patients admitted for drug overdose between 2009 and 2013.
- Standardized follow-up assessed overdose recurrence, long-term mortality, and quality of life.
Main Results:
- At 4-year follow-up, 33.3% of ICU patients and 36.3% of general ward patients experienced further self-harm.
- Mortality was 10% in ICU patients and 5% in general ward patients; self-harm was a dominant cause of death.
- Previous overdose attempts predicted future overdoses and self-harm (OR, 2.34). EQ-5D scores were low, particularly for anxiety/depression, usual activities, and pain/discomfort.
Conclusions:
- Drug overdose patients admitted to ICU and general wards share similar high prevalences of psychiatric disease and comparable outcome profiles.
- Frequent overdoses and a 10% 4-year mortality rate (with self-harm as the leading cause) are significant concerns for ICU-admitted patients.
- Survivors report a poor quality of life, highlighting the need for comprehensive long-term care strategies.
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