https://doi.org/10.4081/ecj.2024.12945
0
0
0
0
Smart Citations
0
0
0
0
Citing PublicationsSupportingMentioningContrasting
View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

Emergency department poisoning and toxicology patients admitted to the high dependency and intensive care units: an eight-year analysis

Authors

Abhay Kant
dr.abhaykant2007@gmail.com
Accident and Emergency Department, Changi General Hospital, Singapore.
Rupeng Mong
Accident and Emergency Department, Changi General Hospital, Singapore.
Gabriel Joseph Arciaga
https://orcid.org/0009-0002-4816-9043
Accident and Emergency Department, Changi General Hospital, Singapore.
Kelvin Kaibin Kuan
https://orcid.org/0000-0002-1246-0237
Accident and Emergency Department, Changi General Hospital, Singapore.
Hock Heng Tan
Accident and Emergency Department, Changi General Hospital, Singapore.

Data on patients with poisoning requiring ICU (Intensive Care Unit) & HD (High Dependency) care in Singapore is inadequate. In this study, we describe the epidemiological, clinical characteristics, implicated agents, interventions, and outcomes of patients with toxic exposures admitted to HD & ICU. We conducted a retrospective and observational study. Hospital records of all cases referred to CGH Toxicology Service from 1 January 2015 to 31 December 2022 were reviewed. A total of 245 (9.6%) out of 2547 patients reviewed required HD or ICU care. 131 patients were admitted to ICU, while 114 patients were admitted to HD beds. Amongst those admitted to ICU, male to female ratio was approximately 60:40, and the commonest age group was 31-40 years old (19.9%), while deliberate self-harm poisoning accounted for 52.7 % of these cases. Benzodiazepines, anti-psychotics, anti-depressants, and opioids were most involved.The fatality rate was 3.2 %. Cardiotoxic drugs, anti-psychotics, and anti-depressants were associated with most fatalities. Benzodiazepines, anti-psychotics, anti-depressants, and opioids were the most associated with ICU admissions, while cardiotoxic drugs, anti-psychotics, and anti-depressants were associated most with mortalities.

Dimensions

Altmetric

PlumX Metrics

Plum Print visual indicator of research metrics
  • Mentions
    • News Mentions: 1
see details

Downloads

Citations

Crossref
0
Scopus
0
Google Scholar
Europe PMC
Ponampalam R, Tan HH, Ng KC, et al. Demographics of toxic exposures presenting to three public hospital emergency departments in Singapore 2001-2003. Int J Emerg Med 2009;2:25-31. DOI: https://doi.org/10.1007/s12245-008-0080-9
Chiu LQ, Lim BL, Vasu A, et al. Poison exposure in the emergency department: a Singaporean experience. Hong Kong J Emerg Med 2011;18:197-203. DOI: https://doi.org/10.1177/102490791101800402
Arciaga GJ, Tan HH, Kuan KK, et al. A 24/7 hospital toxicology service: Experience of a new start-up. Proceedings of Singapore Healthcare. 2018 DOI: https://doi.org/10.1177/2010105818758783
SY Tay, DYH Tai, E Seow, YT Wang. Annals of Academic Medicine Singapore. 1998.
SingHealth Overview. Accessed on 15 October 2023. Available from: https://www.singhealth.com.sg/about-singhealth/newsroom/Documents/SingHealth-AR17-Insert.pdf
World Health Organization. Poisoning severity score. Accessed on 16 October. Available from: 2023www.who.int/ipcs/poisons/pss.pdf
World Health Organization. The use of the WHO-UMC system for standardised case causality assessment. Uppsala, Sweden: The Uppsala Monitoring Centre, 2005.
Mowry JB, Spyker DA, Brooks DE, et al. 2015 Annual report of the american association of poison control centers’ National Poison Data System (NPDS): 33rd Annual Report. Clin Toxicol (Phila) 2015;53:962-1147. DOI: https://doi.org/10.3109/15563650.2015.1102927
Krenz JR, Kaakeh Y. An Overview of Hyperinsulinemic-Euglycemic Therapy in Calcium Channel Blocker and β-blocker Overdose. Pharmacotherapy 2018;38:1130-42 DOI: https://doi.org/10.1002/phar.2177
Weinberg RL, Bouchard NC, Abrams DC, et al. Venoarterial extracorporeal membrane oxygenation for the management of massive amlodipine overdose. Perfusion 2014;29:53-6. DOI: https://doi.org/10.1177/0267659113498807
Koschny R, Lutz M, Seckinger J, et al. Extracorporeal life support and plasmapheresis in a case of severe polyintoxication. J Emerg Med 2014;47:527-31. DOI: https://doi.org/10.1016/j.jemermed.2014.04.044
Extrip Blood Purification technology. Accessed on 16 October 2023. Available from: https://www.extrip-workgroup.org/copy-of-home
Ghannoum M, Hoffman RS, Gosselin S, et al. Use of extracorporeal treatments in the management of poisonings. Kidney Int 2018;94:682-8. DOI: https://doi.org/10.1016/j.kint.2018.03.026
Cannon CP. Importance of TIMI 3 flow. Circulation 2001;104:624-6. DOI: https://doi.org/10.1161/01.CIR.104.6.624
Orsini J, Din N, Elahi E, et al. Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU. J Community Hosp Intern Med Perspect 2017;7:202-7. DOI: https://doi.org/10.1080/20009666.2017.1356189
Botti P, Cipriani F, Dannaoui B, et al. Intossicazioni acute e avvelenamenti nei Dipartimenti di Emergenza e Urgenza in Italia [Acute intoxications and poisonings in Italian Emergency Rooms]. Ann Ist Super Sanita 2006;42:287-97.
Brandenburg R, Brinkman S, de Keizer NF, et al. The need for ICU admission in intoxicated patients: a prediction model. Clin Toxicol (Phila) 2017;55:4-11. DOI: https://doi.org/10.1080/15563650.2016.1222616
Banderas-Bravo ME, Arias-Verdú MD, Macías-Guarasa I, et al. Patients admitted to three spanish intensive care units for poisoning: type of poisoning, mortality, and functioning of prognostic scores commonly used. Biomed Res Int 2017;2017:5261264. DOI: https://doi.org/10.1155/2017/5261264
Tsirigotis K, Gruszczynski W, Tsirigotis M. Gender differentiation in methods of suicide attempts. Med Sci Monit 2011;17:PH65-70. DOI: https://doi.org/10.12659/MSM.881887
Geith S, Lumpe M, Schurr J, et al. Clinical course and demographic insights into suicide by self-poisoning: patterns of substance use and socio-economic factors. Soc Psychiatry Psychiatr Epidemiol 2024 Sep 24. doi: 10.1007/s00127-024-02750-x. Epub ahead of print. DOI: https://doi.org/10.1007/s00127-024-02750-x
Manini AF, Kumar A, Olsen D, et al. Utility of serum lactate to predict drug-overdose fatality. Clin Toxicol (Phila) 2010;48:730-6. DOI: https://doi.org/10.3109/15563650.2010.504187
Golaghaei A, Hassanian-Moghaddam H, Shadnia S, et al. Potential prognostic roles of serum lactate and Creatine kinase levels in poisoned patients. BMC Emerg Med 2020;20:32. DOI: https://doi.org/10.1186/s12873-020-00326-x
Uzucek DM, Yildiz D, Urfalioglu AB, et al. Lactate for predicting the prognosis of multi-drug poisoned patients. Ethiop J Health Sci 2023;33:107-14. DOI: https://doi.org/10.4314/ejhs.v33i1.14
Beauchamp GA, Hendrickson RG, Hatten BW, on Behalf of the Toxicology Investigators Consortium (ToxIC). Endotracheal intubation for toxicologic exposures: A retrospective review of toxicology investigators consortium (toxic) cases. J Emerg Med 2016;51:382-8.e11. DOI: https://doi.org/10.1016/j.jemermed.2016.05.056
Beauchamp GA, Giffin SL, Horowitz BZ, et al. Poisonings Associated with Intubation: US National Poison Data System Exposures 2000-2013. J Med Toxicol 2016;12:157-64. DOI: https://doi.org/10.1007/s13181-015-0528-2
Ramanathan K, Mohanty B, Tang S, MacLaren G. Extracorporeal therapy for amlodipine poisoning. J Artif Organs 2020;23:183-6. DOI: https://doi.org/10.1007/s10047-019-01132-4
Wang GS, Levitan R, Wiegand TJ, et al. Extracorporeal Membrane Oxygenation (ECMO) for Severe Toxicological Exposures: Review of the Toxicology Investigators Consortium (ToxIC). J Med Toxicol 2016;12:95-9. DOI: https://doi.org/10.1007/s13181-015-0486-8
Ramanathan K, Tan CS, Rycus P, MacLaren G. Extracorporeal membrane oxygenation for poisoning in adult patients: outcomes and predictors of mortality. Intensive Care Med 2017;43:1538–9. DOI: https://doi.org/10.1007/s00134-017-4842-9
Rogliano PF, Voicu S, Labat L, et al. Acute poisoning with rhabdomyolysis in the intensive care unit: risk factors for acute kidney injury and renal replacement therapy requirement. Toxics 2020;8:79. DOI: https://doi.org/10.3390/toxics8040079
Taghaddosinejad F, Sheikhazadi A, Yaghmaei A, et al. Epidemiology and treatment of severe poisoning in the intensive care unit: lessons from a one-year prospective observational study. J Clinic Toxicol 2012;S1:007.
D Clark, DB Murray, D Ray. Epidemiology and outcomes of patients admitted to critical care after self-poisoning. J Intensive Care Soc 2011;12:4. DOI: https://doi.org/10.1177/175114371101200405
Rezar R, Jung C, Mamandipoor B, et al. Management of intoxicated patients - a descriptive outcome analysis of 4,267 ICU patients. BMC Emerg Med 2022;22:38. DOI: https://doi.org/10.1186/s12873-022-00602-y

How to Cite

Kant, A., Mong, R., Arciaga, G. J., Kuan, K. K., & Tan, H. H. (2024). Emergency department poisoning and toxicology patients admitted to the high dependency and intensive care units: an eight-year analysis. Emergency Care Journal. https://doi.org/10.4081/ecj.2024.12945
Copyright (c) 2024 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.