Poisoning related admissions to the Intensive Therapy Unit at the general teaching hospital in Malta

Abstract

Background: Studies worldwide have shown a trend toward an increase in number of Intensive Therapy Unit (ITU) admissions due to intentional and unintentional poisoning. However, there is a paucity of publications and knowledge about the characteristics and demographics of patients admitted to local ITUs for the management of such conditions. The aim of this study was to conduct a fully anonymised retrospective analysis of patients admitted to the ITU at the Mater Dei Hospital, the general teaching hospital in Malta with poisoning related issues and to identify emerging admission patterns and assess the progress and outcome of such patients. Methods: A detailed fully anonymised retrospective observational study from anonymised patient records was conducted following ethics and data protections approval. The data of all patients admitted to the ITU over 18 years of age for any poisoning related issues from the 1st of January 2015 to the 31st of December 2021 were analysed. Medical information collected included the nature of drug toxicity or overdose, including reason for admission to ITU, management in ITU, length of stay in ITU and outcome of patient. The data was analysed using the statistical package for social sciences program (SPSS). Results: In the period from January 1, 2015, to December 31, 2021, there were a total of 3,394 adult patient admissions to the Intensive Care Unit (ITU) at Mater Dei Hospital. Among these admissions, a total of 252 were related to poisoning, and thus included in this study. The age of patients ranged from 18 to 87 years, with a median age of 39.5 years (Interquartile Range [IQR]: 28 to 55 years). Gender distribution showed 94 females (37.3%) and 158 males (62.7%). The study identified seven most frequently involved causes of poisonings, namely recreational drugs(19.9%), sedatives (13.9%), antidepressants (11.3%), antipsychotics (11.3%), alcohol (10.7%), analgesics (6.9%) and antihypertensives (4.6%). Patient survival rate was 97.6%, and the mortality rate was 2.4%. Among the findings, it was observed that elderly patients over 60 years old with comorbidities experienced a longer duration of stay in the ITU compared to younger patients. Conclusion: This study, being the first of its kind in Malta, provides key insights into the critical issue of poisoning-related admissions to the intensive therapy unit in Malta. By investigating the diverse factors contributing to these admissions, such as the demographics, common substances involved in overdose, Glasgow Coma Scale score at time of hospital admission, intent of overdose, management of poisoning patients in ITU, patient outcome, and length of stay in ITU, this study offers a thorough understanding of the various complexities involved. Moreover, this research highlights the necessity for further study in the field of toxicology in order to ensure better patient care and patient outcomes.