Adult poisoning-related admissions to the intensive care unit at the Mater Dei Hospital, Malta (2015–2021)

Abstract

Introduction: Studies worldwide have demonstrated an increasing number of intensive care unit admissions due to intentional and unintentional poisoning. However, data on the characteristics and demographics of such patients in Malta remain limited.

Methods: A retrospective study of fully anonymized patient records was conducted following ethics and data protection approval. Adult patients (over 18 years old) admitted to the intensive care unit at the Mater Dei Hospital, Malta, as a result of acute poisoning between 1 January 2015 and 31 December 2021 were included. Data collected included the type of drug toxicity or poisoning, reason for admission, management, length of stay and patient outcome.

Results: Among 3,394 adult intensive care unit admissions during the study period, 252 (7.4%) were related to poisoning. Patient ages ranged from 18 years to 87 years, with a median age of 39.5 years. There were 94 females (37.3%) and 158 males (62.7%). The seven most frequently involved causes of poisonings were recreational drugs (19.9%, most commonly cocaine), sedatives (13.9%, benzodiazepines), antidepressants (11.3%, mainly tricyclic antidepressants), antipsychotics (11.3%, mainly atypical antipsychotics), ethanol taken alone (10.7%), analgesics (6.9%, mainly paracetamol) and antihypertensives (4.6%, mainly diuretics). The patient survival rate was 97.6%.

Discussion: These findings, consistent with other international studies, offer valuable insights into the demographics, types, and outcomes of poisoning-related admissions in Malta. The data may assist clinicians, toxicologists, and public health officials to identify risks, improve patient management and guide prevention strategies.

Conclusions: There were 252 adult poisoning-related admissions to the intensive care unit, Mater Dei Hospital, Malta, between 2015 and 2021, and males accounted for 62.7% of these cases. Overall, intentional poisonings accounted for 50.4% of admissions. The seven most frequently occurring poisonings were due to recreational drugs (19.9%), sedatives (13.9%), antidepressants (11.3%), antipsychotics (11.3%), ethanol taken alone (10.7%), analgesics (6.9%), and antihypertensives (4.6%). The survival rate was 97.6%.