Acute Intoxications Admitted to the Intensive Care Unit: A Retrospective Cohort Study.

Area of Science:

• Critical Care Medicine
• Toxicology
• Public Health

Background:

• Acute intoxications represent a significant, under-researched cause of critical illness.
• Limited data and lack of clinical guidelines impede timely recognition and management of poisoning.
• Poisoning is a leading cause of injury-related mortality worldwide.

Purpose of the Study:

• To characterize intensive care unit (ICU) admissions for acute intoxications at an Italian tertiary hospital.
• To identify factors influencing patient outcomes in acute intoxication cases.
• To evaluate the impact of early recognition on survival rates.

Main Methods:

• Retrospective cohort study of 117 patients (126 episodes) admitted to ICUs from January 2009 to May 2024.
• Data collection included demographics, substance type, intoxication severity, treatments, and outcomes.
• Analysis focused on factors associated with ICU and hospital mortality and length of stay.

Main Results:

• Intentional self-poisoning, frequently with psychotropic drugs, was most common.
• Multiple-substance intoxications (55.6%) had shorter ICU stays and lower mortality than single-substance cases.
• Overall ICU mortality was 5.1%, hospital mortality 6%; early recognition improved survival, while low pH and high lactate correlated with increased mortality.

Conclusions:

• Prompt identification of acute intoxications is critical for improving ICU and hospital outcomes.
• Early intervention and standardized treatment protocols are essential for enhancing prognosis and reducing mortality in poisoning patients.
• Further research into specific toxic agents and management strategies is warranted.