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Critical Care

Open Access

Intensive care expenditure on overdose admissions

  • MA Staber1,
  • JL Plenderleith1,
  • ES Wilson1 and
  • AR Binning1
Critical Care20037(Suppl 2):P245

Published: 3 March 2003


Intensive Care UnitIntensive Care Unit AdmissionDrug OverdoseIntensive Care Unit MortalityIntensive Care Unit Population


In Scotland, 3% of intensive care admissions relate to drug overdoses. In Greater Glasgow, €12 million are annually spent on drug misuse services. UK studies have related a therapeutic intervention scoring system (TISS) to expenditure [1]. We investigated the costs of overdose admissions in a teaching hospital intensive care unit (ICU) from 1 January 1997 to 31 December 2000.


Data were collected prospectively for all overdose admissions to the intensive care unit using Ward Watcher software (Critical Care Audit Ltd, Yorkshire, UK).


A total of 3.8% (n = 70) of all ICU admissions (n = 1846) were due to overdoses. During the same period, the Accident & Emergency Department admitted 4097 patients with the same diagnosis. Comparing overdose patients with the whole ICU population, the mean age was 36.6 years versus 56.5 years; mean stay was 1 day (median 0.8) versus 4.02 days (median 1.8); TISS score was 41.8 ± 30.3 versus 144.7 ± 171.7; and available APACHE scores were 15 ± 6.5 versus 18.84 ± 7.48. Overdose mortality was 3%. Overall ICU mortality was 23%.

Over the 4 years, the whole ICU population accumulated a TISS score of 266,360. On a basis of €25–31 per TISS point, this relates to an expenditure of €6.7–8.3 million. The overdose group collected a score of 2926, giving an overall cost of €0.07–0.09 million.


Drug overdoses accounted for 3.8% of ICU admissions but only for 1.1% of the overall treatment costs. Only 1.7% of overdose hospital admissions required ICU admission. Nevertheless, drug overdose admissions are a significant component of the workload and costs of our ICU.

Table 1





Mortality (%)

Stay in days (mean [median])

APACHE score (mean [SD])

TISS score (mean [SD])

€ million

€ million

All ICU admissions (n = 1846)


4.0 (1.8)

18.84 (7.48)

144.7 (171.7)



Overdose admissions (n = 70)


1.0 (0.8)

15.0 (6.5)

41.8 (30.3)



Authors’ Affiliations

Department of Anaesthesia, Intensive Care, Western Infirmary, Glasgow, UK


  1. Dickie H, Vendo A, Dundas R, Treacher DF, Leach RM: Relationship between TISS and ICU cost. Intensive Care Med 1998, 24: 1009-1017. 10.1007/s001340050709View ArticlePubMedGoogle Scholar


© BioMed Central Ltd 2003