The functional outcome and recovery of patients admitted to an intensive care unit following drug overdose: a follow-up study.
Patients who have overdosed on drugs commonly present to emergency departments, with only the most severe cases requiring intensive care unit (ICU) admission. Such patients typically survive hospitalisation. We studied their longer term functional outcomes and recovery patterns which have not been well described. All patients admitted to the 18-bed ICU of a university-affiliated teaching hospital following drug overdoses between 1 January 2004 and 31 December 2006 were identified. With ethical approval, we evaluated the functional outcome and recovery patterns of the surviving patients 31 months after presentation, by telephone or personal interview. These were recorded as Glasgow outcome score, Karnofsky performance index and present work status. During the three years studied, 43 patients were identified as being admitted to our ICU because of an overdose. The average age was 34 years, 72% were male and the mean APACHE II score was 16.7. Of these, 32 were discharged from hospital alive. Follow-up data was attained on all of them. At a median of 31 months follow-up, a further eight had died. Of the 24 surviving there were 13 unemployed, seven employed and four in custody. The median Glasgow outcome score of survivors was 4.5, their Karnofsky score 80. Admission to ICU for treatment of overdose is associated with a very high risk of death in both the short- and long-term. While excellent functional recovery is achievable, 16% of survivors were held in custody and 54% unemployed.
Department of Anaesthesia and Intensive Care, Mater Misericordiae University Hospital, Dublin, Ireland.
B P
BP
O'Brien
D
D
Murphy
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I
Conrick-Martin
B
B
Marsh
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000009:adverse effects; D003042:Cocaine / Q000009:adverse effects; D062787:Drug Overdose; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D003932:Heroin / Q000009:adverse effects; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D007362:Intensive Care Units; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000401:mortality*; D016896:Treatment Outcome; D055815:Young Adult
D000701:Analgesics, Opioid; D013287:Illicit Drugs; D003932:Heroin; D003042:Cocaine