Aspiration pneumonia following severe self-poisoning.
OBJECTIVE
To investigate the risk factors of aspiration pneumonia following severe self-poisoning.


METHODS
Patients treated due to severe self-poisoning in the ICU of Oulu University Hospital, Oulu, Finland during 1.11.1989-31.10.2000 were analyzed retrospectively.


RESULTS
28.4% of 257 patients fulfilled the criteria of aspiration pneumonia. An unconscious patient who was not intubated until arrival at the emergency room (ER) had an odds ratio (OR) of 3.34 (CI 1.3-8.7) for aspiration pneumonia. If the patient was intubated at the first contact with health care providers, OR was 1.8 (CI 0.6-5.7). The use of gastric lavage or activated charcoal in the case of a non-intubated unconscious patient led to ORs of 2.7 (CI 0.8-9.3) and 3.7 (CI 1.01-12.5), respectively. The mean length of ICU stay was 0.9 (CI 0.8-0.9) days among patients without aspiration pneumonia and 1.9 (CI 1.3-2.6) days among those with aspiration pneumonia. The mean length of hospital stay was 2.8 (CI 2.5-3.1) days among the patients without aspiration pneumonia and 6.5 (CI 5.3-7.6) days among those with aspiration pneumonia.


CONCLUSIONS
To avoid aspiration pneumonia intubation of an unconscious patient on scene before arrival at the ER is recommended. The use of gastric lavage and activated charcoal increase the risk of aspiration pneumonia if the patient is unconscious and not intubated. Aspiration pneumonia significantly prolongs the length of ICU and hospital stay.
Liisanantti
Janne
J
Department of Anesthesiology, Oulu University Hospital, PO Box 21, 90029 OUH, Oulu, Finland.
Kaukoranta
Päivi
P
Martikainen
Matti
M
Ala-Kokko
Tero
T
D000328:Adult; D002606:Charcoal; D005260:Female; D005751:Gastric Lavage; D006801:Humans; D007442:Intubation, Intratracheal; D007902:Length of Stay; D008297:Male; D016017:Odds Ratio; D011015:Pneumonia, Aspiration / Q000209:etiology* / Q000517:prevention & control; D011041:Poisoning / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications; D014474:Unconsciousness
D002606:Charcoal