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Title: Long-term outcomes after severe drug overdose.
Austin Authors: Wong, Lee Y ;Bellomo, Rinaldo ;Robbins, Raymond J ;Martensson, Johan;Kanaan, Richard A A ;Newton, Richard;Hu, Chih-Chiang;Taylor, David McD 
Affiliation: Department of Psychiatry, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Administrative Informatics,
Department of Emergency Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Anaesthesia and Intensive Care Medicine, Karolinska University Hospital, Stockholm, Sweden
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Dec-2016
Publication information: Critical Care and Resuscitation 2016; 18(4): 247-254
Abstract: The long-term outcomes of patients with drug overdose admitted to the intensive care unit compared with those admitted to general wards have not been assessed. We aimed to compare the recurrence of overdose, mortality after hospital discharge, cause of death and quality-of-life scores (using the EQ-5D questionnaire) between the ICU patients and general ward patients. We performed a retrospective cohort study of 102 ICU patients with drug overdose and 102 matched general ward patients with drug overdose in a university-affiliated teaching hospital between 2009 and 2013. We undertook standardised follow-up of patients for recurrence of overdose, long-term mortality and quality-oflife assessment. At 4-year follow-up, 33.3% of ICU patients had experienced further self-harm attempts, compared with 36.3% of general ward patients (P = 0.66). Ten ICU patients (10%) and five general ward patients (5%) had died. Causes of death included hanging in three patients and drug overdose in another three. On multivariate regression analysis, previous overdose attempts significantly predicted future overdoses and self-harm (odds ratio, 2.34; 95% CI, 1.27-4.30; P = 0.006). Overall, 101 patients (49.5%) were lost to follow-up and eight (3.9%) refused participation. For those remaining, EQ-5D scores were low, especially in the dimensions of anxiety/depression, usual activities and pain/discomfort. ICU and general ward patients with overdose have similar, overwhelming prevalences of psychiatric disease, and similar outcome profiles. Such patients experience frequent overdoses and, despite being young, if admitted to the ICU, have a 10% 4-year mortality, with self-harm the dominant cause of death. Finally, among survivors who responded to the follow-up questionnaire, quality of life is poor.
ORCID: 0000-0003-0992-1917
Journal: Critical Care and Resuscitation
PubMed URL: 27903206
ISSN: 1441-2772
Type: Journal Article
Appears in Collections:Journal articles

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