Is It Necessary to Admit All Drug Intoxications to Intensive Care Unit?

Objective: 5.5-12.8% of drug intoxications attending to the emergency departments are admitted to the intensive care unit (ICU). In our country, this rate can reach up to 37%. Most of these patients do not receive any treatment that requires intensive care, but they are admitted for observation only. The aim of this study was to retrospectively examine the drug intoxication patients in ICU and to determine how many of these patients really needed intensive care admission. Materials and Methods: Cases of drug intoxications admitted to our intensive care unit between March 2016 and March 2018 were retrospectively evaluated. Demographic data, toxicological characteristics, vital signs at admission, presence of ICU admission criteria, intensive care treatments, duration of stay in ICU, prognosis and mortalities were investigated retrospectively. Results: Data of 130 patients (40 male/90 female) were evaluated. When drug types were evaluated, multiple drug intake was the first followed by antidepressants and anticonvulsants respectively. At the time of admission to ICU, vital signs of 120 patients were stable. Twenty seven patients had at least one ICU admission criteria. 4 of these patients were on mechanical ventilation; inotropic-vasopressor treatment was applied in 3 patients. The number of patients requiring treatment that has to be performed in ICU was 8. No complication developed in patients whose vital signs were stable on admission and did not have any of the ICU admission criteria. Seven of the patients were referred to the ward and one was to the nephrology intensive care unit, 122 of them were discharged home directly. The total length of stay in the ICU was 251.5 days. Conclusion: We think that constituting clear criteria for admission to ICU for patients presenting with drug intoxications and follow-up of some patients in the emergency departments or wards will reduce unnecessary bed occupation in ICUs.