Objective: The primary objective of this epidemiological study was to systematically examine the demographic attributes of patients accessing the emergency department due to drug overdose. The study further aims to evaluate the imperative for hospitalization or intensive care and to meticulously scrutinize disparities in the clinical trajectory, specifically distinguishing between inadvertent and intentional substance ingestion.
Material and Methods: Patients admitted to the emergency department because of drug intake were retrospectively evaluated. The analysis encompassed the evaluation of presenting symptoms and emergency department interventions. Parameters such as the duration of emergency department stay, blood tests conducted during the initial assessment, requested consultations, necessity for clinic or intensive care unit hospitalization, and administration of a specific antidote in the emergency setting were systematically examined. Additionally, the impact of antidote use on patient outcomes, as well as the correlation between antidote administration, hospitalization requirements, and subsequent follow-up for referred patients, were subjected to comparative analysis.
Results: Among the examined patient cohort, a predominant 156 individuals (89.7%) manifested a deliberate suicidal intent, while 34 patients (20.6%) had a documented history of psychiatric illness. It is noteworthy that a mere 3 patients (1.8%) were referred to our institution, and conspicuously, none of these cases warranted the administration of antidotes. In totality, the imperative for antidote utilization was identified in 15 patients (8.7%). A statistically significant differentiation emerged between admissions characterized as suicidal and accidental, particularly with regard to 28-day mortality (p=0.001), The mortality rate in cases of accidental admissions stood at 17.6%, exhibiting statistical significance. However, no statistically significant relationships were discerned between polypharmacy, antidote utilization, and 28-day mortality (p=0.164, p=0.246).
Conclusion: Identification of critically ill patients, consideration of specific antidote treatments, strategic determination of treatment options from the point of initial presentation, foresight into potential additional pathologies during follow-up, and recognition of the potential need for a multidisciplinary approach within the scope of third-tier health services collectively constitute integral facets of an effective and comprehensive treatment paradigm for cases involving drug overdose. These measures are essential for ensuring a nuanced and thorough approach to address the evolving clinical needs of affected individuals.
Keywords: Intoxication, drug-related intoxication, antidote use, emergency department
