Independent risk factors for a complicated hospital course in intensive care unit overdose patients. Issue 2 (17th September 2014)

• Record Type: Journal Article
• Authors: Tarui, Takehiko; Yoshikawa, Kei; Miyakuni, Yasuhiko; Kaita, Yasuhiko; Tamada, Nao; Matsuda, Taketo; Miyauchi, Hiroshi; Yamada, Kenji; Matsuda, Takeaki; Yamaguchi, Yoshihiro
• Is Part Of: Acute medicine & surgery. Volume 2:Issue 2 (2015)
• Page Start: 98
• Page End: 104
• Publication Date: 2014-09-17
• Subjects: Surgery -- Periodicals; Medical emergencies -- Periodicals; 617.005
• DOI: 10.1002/ams2.77
• Languages: English
• ISSNs: 2052-8817

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ams277-sec-0001" sec-type="section"> <title>Aim</title> <p>The purpose of the present study was to identify risk factors associated with a complicated hospital course in overdose patients admitted to the intensive care unit.</p> </sec> <sec id="ams277-sec-0002" sec-type="section"> <title>Methods</title> <p>A total of 335 overdose patients were retrospectively studied in the surgical and medical intensive care unit of an academic tertiary hospital. Factors possibly associated with a complicated hospital course were evaluated. Complicated hospital course was defined as the occurrence of pneumonia, rhabdomyolysis, decubitus ulcer, nerve palsy, prolonged intubation, prolonged hospitalization, or death.</p> </sec> <sec id="ams277-sec-0003" sec-type="section"> <title>Results</title> <p>Of the 335 overdose patients, 93 (27.8%) had a complicated hospital course. Complicated hospital course was found to be associated with a high number of ingested pills (median, 135 [interquartile range, 78–240] versus 84 [53–134] tablets, <italic>P</italic> < 0.0001), low Glasgow Coma Scale score on admission (7 [3–11] versus 13 [8–15], <italic>P</italic> < 0.0001), and a high serum lactate level on admission (1.8 [1.0–3.0] versus 1.4 [0.9–2.0] mg/dL, <italic>P</italic> < 0.01) on univariate analysis of these factors in patients with and without a complicated hospital course. The independent risk factors for a complicated hospital course identified on multivariate analysis were a high number of ingested pills (≥100 tablets), low admission Glasgow Coma Scale score (<9), and high serum lactate on admission (≥2.0 mg/dL). The probability of a complicated hospital course for patients with 0, 1, 2, or all 3 independent risk factors were 7%, 22%, 40%, and 81%, respectively.</p> </sec> <sec id="ams277-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The total number of ingested pills, admission Glasgow Coma Scale score, and serum lactate level on admission are predictive of a complicated hospital course in overdose patients admitted to the intensive care unit.</p> </sec> </abstract>