title: Early Clinical Outcome of Acute Poisoning Cases Treated in Intensive Care Unit.
abstract: BACKGROUND
  A variety of factors have influenced the significant incidence of morbidity and mortality of acute poisoning and the timely recognition and properly management of critically ill poisoned patients is a key component. The aim of this study is to reveal the reasons for ICU admission of acutely poisoned patients, the main factors influencing the course and outcome of patients in relation with clinical approaches applied, available resources and infrastructure of treatment.
  
  
  METHODS
  This is a retrospective study based on most reachable variables extracted from patients' medical records and ED registers of patients admitted at the medical ICU of "Mother Teresa" University Hospital in Tirana over two (2012-2013) years. Demography, time of exposure, etiology and circumstances of poisonings, assessment and treatment, reasons for ICU admission, course and outcome were duly obtained.
  
  
  RESULTS
  The number of ICU treated patients was 118, consisting in 47.4% (56) males and 52.5% (62) females which represented 10.2% of poisoned patients admitted during this two-year-period in ED and 9.2% of other etiology ICU admitted patients. Mean was 42.6 years for males, and 38 years for females. About 55.9% were urban residents and 44% rural ones. The elapsed time from toxic exposure to treatment initiation had varied between 2-6 hours, 44% arrived in the hospital <4 hours. The toxic exposures were intentional in 87.2% of cases, with a male:female ratio was 0.8:1. Agrochemicals such as Aluminum phosphide and organophosphates were involved in 77.1% of cases. Cardiovascular collapse and respiratory failure were the main clinical syndromes encountered. Mechanical ventilation was required in 31.4% of patients. The length of ICU stay was 2.73 (0.96) days and the mortality was 54.2%.
  
  
  CONCLUSIONS
  This study evidenced that highly lethal toxicants used in poisoning acts such as agrochemicals, high rate of suicide, notwithstanding the infrastructure and resources available employed for ICU patients' treatment, all had played a role in the very high rate of mortality in this cluster of patients.
authors: Division of Emergency and Surgery, University Hospital Center of Tirana, Albania.
authors: Zihni
authors: Z
authors: Sulaj
authors: Division of Emergency and Surgery, University Hospital Center of Tirana, Albania.
authors: Edvin
authors: E
authors: Prifti
authors: Division of Emergency and Surgery, University Hospital Center of Tirana, Albania.
authors: Aurel
authors: A
authors: Demiraj
authors: Division of Emergency and Surgery, University Hospital Center of Tirana, Albania.
authors: Arjana
authors: A
authors: Strakosha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016573:Agrochemicals / Q000506:poisoning; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D062025:Organophosphate Poisoning / Q000628:therapy; D011041:Poisoning / Q000401:mortality / Q000628:therapy*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013406:Suicide, Attempted; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D016573:Agrochemicals
keywords: acute poisoning; aetiology; intensive care unit; mortality; severity of poisoning