Adverse drug reactions and deliberate self-poisoning as cause of admission to the intensive care unit: a 1-year prospective observational cohort study.
OBJECTIVE
The aim of the present study was (1) to determine the prevalence of intensive care unit (ICU) admissions due to an adverse drug reaction (ADR), and (2) to compare affected patients with patients admitted to the ICU for the treatment of deliberate self-poisoning using medical drugs.


METHODS
Prospective observational cohort study.


METHODS
Fourteen bed medical ICU including an integrated intermediate care (IMC) section at a tertiary referral center.


METHODS
A total of 1,554 patients admitted on 1 January 2003 to 31 December 2003.


RESULTS
Ninety-nine patients were admitted to the ICU with a diagnosis of ADR (6.4% of all admissions), 269 admissions (17.3%) were caused by deliberate self-poisoning. Patients admitted for treatment of ADR had a significantly higher age, a longer treatment duration in the ICU, a higher SAPS II score, and a higher 6-month mortality than those with deliberate self-poisoning. Most patients (71.7%) suffering from ADR required advanced supportive care in the ICU while the majority of patients (90.7%) with deliberate self-poisoning could be sufficiently treated in the IMC area. All diagnostic and therapeutic procedures in the ICU except mechanical ventilation were significantly more often performed in patients with ADR.


CONCLUSIONS
This study provides further evidence that ADR is a frequent cause of admission to medical ICUs resulting in a considerable use of ICU capacities. In the present setting patients with ADR required longer and more intense medical treatment in the ICU than those with deliberate self-poisoning.
Schwake
Lukas
L
Department of Internal Medicine IV (Gastroenterology, Infectious Diseases, Intensive Care Medicine), Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. lukas_schwake@gmx.net
Wollenschläger
Ines
I
Stremmel
Wolfgang
W
Encke
Jens
J
D000328:Adult; D000368:Aged; D001569:Benzodiazepines / Q000009:adverse effects / Q000506:poisoning*; D015331:Cohort Studies; D004232:Diuretics / Q000009:adverse effects / Q000506:poisoning*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D019370:Observation; D010343:Patient Admission / Q000706:statistics & numerical data*; D011041:Poisoning / Q000150:complications* / Q000401:mortality / Q000534:rehabilitation*; D015995:Prevalence; D011446:Prospective Studies; D011998:Recreation; D016728:Self-Injurious Behavior / Q000150:complications* / Q000534:rehabilitation*
D004232:Diuretics; D001569:Benzodiazepines