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Retrospective study of patients following deliberate self-poisoning admitted to Cardiff and Vale NHS critical care services between April 2006 and December 2007

Introduction

There is a paucity of data regarding the demographics and the type of drugs ingested by patients who require admission to critical care following deliberate self-poisoning (DSP). Critical care admissions place a large economic burden on the health care system, and potential measures to prevent critical care admissions should be taken. Ingestion of antihypertensive medication, coma upon presentation, and presentation to the emergency department less than 2 hours after ingestion are predictive of ICU admission. Our aim was to establish the incidence of DSP, to assess the demographics, and to identify factors that may contribute to multiple admissions for DSP.

Methods

Data were retrieved from the Riyadh Intensive Care Programme (RIP) database for each case of DSP between April 2006 and October 2007 that required critical care. Case notes were reviewed and the following data recorded: type of poison ingested, past medical history, past psychiatric history, previous ICU admission for DSP and demographics.

Results

The RIP database identified 64 episodes of DSP involving 55 patients. The mean age was 40 years (26 males, 29 females). Forty-eight episodes required level 3 care. Forty-one patients required intubation. The average length of stay was 2.5 days. Nine patients (16.3% admissions) had more than one admission to the ICU during the study period. Of these, seven were female, average age 35 years, and two male, mean age 50 years. The commonest drug in multiple DSP was alcohol, followed by benzodiazepines. Six patients (75%) had a known psychiatric history. Three patients died during this period, one male and two female. Their average age was 46 years. None of these patients had previously presented to critical care. One of the deceased patients had a psychiatric history.

Conclusion

Most of the ICU admissions to Cardiff and Vale NHS trust following multiple DSP episodes involve young females. The most frequently ingested drug is alcohol, and then benzodiazepines. Further targeted psychiatric involvement with young women with a known psychiatric history may be warranted financially to prevent multiple critical care admissions. This may have no impact on overall successful DSP suicides.

References

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Yates, A., Weaver, C. & Parry-Jones, J. Retrospective study of patients following deliberate self-poisoning admitted to Cardiff and Vale NHS critical care services between April 2006 and December 2007. Crit Care 12 (Suppl 2), P361 (2008). https://doi.org/10.1186/cc6582

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