Epidemiological and clinical characteristics of drug-related poisoning presentations to the emergency department: a retrospective analysis

Drug-related poisoning remains a significant public health problem and is a common cause of emergency department (ED) admissions worldwide. The primary objective of this study was to determine the demographic characteristics of patients, the causes of poisoning, and the drug groups responsible for poisoning. This retrospective study included adult patients (≥ 18 years) who presented to a tertiary-care ED with clinically confirmed drug-related poisoning between January 1, 2023, and October 31, 2025. Demographic data, poisoning characteristics, clinical findings, treatment modalities, and outcomes were extracted from electronic medical records. Poisoning severity was assessed using the Poisoning Severity Score (PSS). Univariate and multivariable binary logistic regression analyses were performed to identify factors associated with ICU admission. A total of 488 patients were included. Analgesics (including non-steroidal anti-inflammatory drugs) and antidepressants were the most frequently implicated drug classes. ICU admission from the ED was required in 49 patients (10.0%), while overall mortality was low (0.2%). In univariate analyses, higher PSS scores, lower Glasgow Coma Scale scores, higher total ingested tablet counts, and multiple-drug ingestion were associated with ICU admission. In multivariable analysis, both the poisoning severity score (adjusted OR 2.53, 95% CI 1.56–4.12; p < 0.001) and the total ingested dose, expressed as tablet count (adjusted OR 1.03, 95% CI 1.01–1.04; p = 0.001), remained independently associated with ICU admission. Drug-related poisoning is a frequent reason for ED presentation, predominantly resulting from intentional exposure. The poisoning severity score is a valuable tool for early risk stratification and identification of patients at increased risk for ICU admission.