Life-threatening drug overdose. Precipitants and prognosis

During a four-year period, 255 persons were admitted to a medical intensive care unit 283 times (5% of all admissions) for treatment of drug overdose. Because of the high personal and social costs associated with overdose and the high rate of repeated overdose admissions, we prospectively studied 104 patients who had taken an overdose admitted during a 20-month period to define better the precipitants of overdose and the prognosis after intensive care unit admission for overdose. Of 103 hospital survivors, 88 consented to and could be reached for follow-up (mean duration, ten months). During that time, 8% died (5% by overdose) and 42% had been readmitted for another nonfatal overdose or for psychiatric illness. Prior psychiatric treatment was associated with subsequent readmission; 61% with a history of suicide attempt were readmitted during the follow-up period. Demographic characteristics, psychiatric evaluation, and medical history were not associated with subsequent hospitalization or death from overdose.