Clinical parameters that predict the need for medium or intensive care admission in intentional drug overdose patients: A retrospective cohort study

van den Oever, H. L. A., van Dam, M., van 't Riet, E. & Jansman, F. G. A., 28-Sep-2016, In : Journal of Critical Care. 37, p. 156-161 6 p.

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  • Clinical parameters that predict the need for medium

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INTRODUCTION: Many patients with intentional drug overdose (IDO) are admitted to a medium (MC) or intensive care unit (IC) without ever requiring MC/IC related interventions. The objective of this study was to develop a decision tool, using parameters readily available in the emergency room (ER) for patients with an IDO, to identify patients requiring admission to a monitoring unit.

METHODS: Retrospective cohort study among cases of IDO with drugs having potentially acute effects on neurological, circulatory or ventilatory function, admitted to the MC/IC unit between 2007 and 2013. A decision tool was developed, using 6 criteria, representing intubation, breathing, oxygenation, cardiac conduction, blood pressure, and consciousness. Cases were labeled as 'high acuity' if one or more criteria were present.

RESULTS: Among 255 cases of IDO that met the inclusion criteria, 197 were identified as "high acuity". Only 70 of 255 cases underwent one or more MC/IC related interventions, of which 67 were identified as 'high acuity by the decision tool (sensitivity 95.7%).

CONCLUSION: In a population of patients with intentional drug overdose with agents having potentially acute effect on vital functions, 95.7% of MC/IC interventions could be predicted by clinical assessment, supplemented with electrocardiogram and blood gas analysis, in the ER.

Original languageEnglish
Pages (from-to)156-161
Number of pages6
JournalJournal of Critical Care
Publication statusPublished - 28-Sep-2016

ID: 37956258