A Single Center Retrospective Cohort Study of Auto-intoxicated Patients Admitted to the ICU

A Single Center Retrospective Cohort Study of Auto-intoxicated Patients Admitted to the ICU: Descriptive Analysis

Intentional poisoning is a relevant public health issue responsible for a considerable number of cases of morbidity and mortality worldwide. There are no concrete numbers/investigations of these patients admitted to the ICU at our hospital, with limited insight on their characteristics and outcome.

It is expected that this population of patients is an important burden for the ICU. It can be important to shed a light on prevalence and ratio of intoxicated patients admitted to the ICU in our center.

Furthermore, during the covid-pandemic, we could expect an increase in self-poisoning prevalence due to social restrictions, more limited access to (mental) health care, etc…

Study Overview

• Status: Completed
• Conditions: Intoxication, Depth

Detailed Description

Aim The aims of this study are to quantify the ratio of intensive care admissions attributable to self-poisoning in our hospital, to examine characteristics and outcome of these patients, yearly trends and impact of the covid-pandemic on these variables.

Design A single center retrospective cohort study analysis of patients with self-poisoning admitted to ICU of the Jessa Hospital Hasselt Belgium over a period of 6 years (2017-2022).

Sample size

All patients diagnosed with self-poisoning admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022 were included in the study. This were 377 patients.

Study population

Inclusion and exclusion criteria:

All patients (>14 years of age) diagnosed with self-poisoning and admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022 were included in the study.

Patient admitted for tentamen suicide but not due to intoxication were excluded as well as patients with no medical records in the Jessa hospital.

Primary Outcome The prevalence of auto-intoxicated patients admitted to the ICU together with the mortality rate on the ICU.

Secondary Outcome measurements

Secondary outcome measurement are the ICU and hospital length of stay, ratio of auto-intoxicated patients to all patients admitted at ICU, types of drugs ingested, number of drugs involved, cause of admission, yearly trends and impact of covid-pandemic.

Statistical analysis Data will be presented as mean values +/-SD, numbers(n), and percentages(%) or median (25%, 75% percentile) in case of non-parametric data. Categorical variables are presented as frequencies (%) and groups were compared using Chi-square or Fisher's exact test.

Differences between patients change will be analyzed using the Student t test for continuous outcomes or, in case of non-parametric data, the Mann-Whitney U test. Univariate and multivariate logistic regression models will be used in order to predict mortality. P values <0.05 will be considered statistically significant.

Additional data collection:

Additional collected parameters are listed below and are collected as a standard-of-care in our hospital:

• Demographics: i.e age, gender, BMI
• DNR-code
• Admission route
• Patient state and symptoms: i.e vital signs, GCS, …
• Comorbidities: i.e smoking, obesity, hypertension, diabetes, cardiovascular disease, respiratory disease, malignancies, renal failure, liver failure, neurological conditions, mental state and disease
• Technical investigation results: i.e Laboratory results, ECG, radiological findings, etc…
• Complications: i.e shock, heart failure, sepsis, stroke, etc…
• Ventilation: method, PEEP, FiO2, P/F ratio,…
• Management: i.e antidote, supportive, mechanical ventilation, dialysis, observation,

• Study Type: Observational
• Enrollment (Actual): 377

Contacts and Locations

Study Locations

• Belgium
  • Hasselt, Belgium, 3500
    • Jessa Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

All patients (>14 years of age) diagnosed with self-poisoning and admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022 were included in the study.

Description

Inclusion Criteria:

All patients (>14 years of age) diagnosed with self-poisoning and admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022 were included in the study.

Exclusion Criteria:

Patient admitted for tentamen suicide but not due to intoxication were excluded as well as patients with no medical records in the Jessa hospital.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prevalence of mortality	The prevalence of auto-intoxicated patients admitted to the ICU together with the mortality rate on the ICU.	patient admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ICU length of stay	Length of stay in the ICU	patients admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022
hospital length of stay	Length of stay in the hospital	patients admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022
Relative number of auto-intoxicated patients at ICU	ratio of auto-intoxicated patients to all patients admitted at ICU,	patients admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022
Type	type of drugs ingested by patients admitted to ICU	patients admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022
Impact of COVID-19 pandemic	the impact of the COVID-19 pandemic on the number of auto-intoxicated patients admitted to ICU	patients admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022
number of drugs or medication	number of drugs or medication ingested by patients admitted to ICU	patients admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022
Cause	cause of admission to ICU: emotional, relational, somatic, psychological, financial, workrelated, recreative, other or unknown	patients admitted to the ICU of the Jessa hospital between 01/01/2017 and 31/12/2022

Collaborators and Investigators

• Sponsor: Jessa Hospital

Study record dates

Study Major Dates

• Study Start (Actual): July 3, 2023
• Primary Completion (Actual): September 15, 2023
• Study Completion (Actual): September 15, 2023

Study Registration Dates

• First Submitted: June 28, 2023
• First Submitted That Met QC Criteria: June 28, 2023
• First Posted (Actual): July 6, 2023

Study Record Updates

• Last Update Posted (Actual): September 21, 2023
• Last Update Submitted That Met QC Criteria: September 19, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Chemically-Induced Disorders; Occupational Diseases; Poisoning; Gas Poisoning; Inert Gas Narcosis
• Other Study ID Numbers: f/2023/041

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No