Emergency department poisoning and toxicology patients admitted to the high dependency and intensive care units: an eight-year analysis

Data on patients with poisoning requiring ICU (Intensive Care Unit) & HD (High Dependency) care in Singapore is inadequate. In this study, we describe the epidemiological, clinical characteristics, implicated agents, interventions, and outcomes of patients with toxic exposures admitted to HD & ICU. We conducted a retrospective and observational study. Hospital records of all cases referred to CGH Toxicology Service from 1 January 2015 to 31 December 2022 were reviewed. A total of 245 (9.6%) out of 2547 patients reviewed required HD or ICU care. 131 patients were admitted to ICU, while 114 patients were admitted to HD beds. Amongst those admitted to ICU, male to female ratio was approximately 60:40, and the commonest age group was 31-40 years old (19.9%), while deliberate self-harm poisoning accounted for 52.7 % of these cases. Benzodiazepines, anti-psychotics, anti-depressants, and opioids were most involved.The fatality rate was 3.2 %. Cardiotoxic drugs, anti-psychotics, and anti-depressants were associated with most fatalities. Benzodiazepines, anti-psychotics, anti-depressants, and opioids were the most associated with ICU admissions, while cardiotoxic drugs, anti-psychotics, and anti-depressants were associated most with mortalities.