Therefore, identification of factors associated with the severity of poisoning would be helpful to timely initiate medically indicated steps, such as an intensive care transfer, protective intubation or establishing the indication for antidote administration. Especially in the early phase of intoxication, where the clinical severity may not have reached its peak, a valid risk assessment may be challenging at the time of admission.

However, it is often difficult, even for an experienced emergency or intensive care physician, to predict the clinical course of an intoxication at admission. Although the in-hospital mortality rate is rather low at 0.5% to 4% reported in the literature, it is crucial to identify patients at risk of death. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: The authors received no specific funding for this work.Ĭompeting interests: The authors have no conflicts of interest to declare that are relevant to the content of this article.ĭeliberate self-poisoning is a common reason for emergency department (ED) and intensive care unit (ICU) admissions accounting for 0.4% to 10% of all ED attendances and 2.3% to 17.3% of all ICU admissions. Received: JanuAccepted: SeptemPublished: November 3, 2022Ĭopyright: © 2022 Geith et al.

PLoS ONE 17(11):Įditor: Vipa Thanachartwet, Mahidol University, Faculty of Tropical Medicine, THAILAND (2022) Characteristics and predictive factors of severe or fatal suicide outcome in patients hospitalized due to deliberate self-poisoning. Determination of these risk factors at admission could be potentially used to guide treatment intensification in patients hospitalized due to deliberate self-poisoning.Ĭitation: Geith S, Lumpe M, Schurr J, Rabe C, Ott A, Zellner T, et al. The conclusion for clinical practice is that male patients hospitalized due to self-poisoning, with a low initial GCS score, who did not co-ingest alcohol, attempted suicide with non-pharmaceutical substances or antidepressants are at a higher risk of severe/fatal outcome of suicide. In contrast, female gender (OR 0.4 95%CI 0.2, 0.81 p = 0.011), not using an antidepressant as the method for self-poisoning (OR 0.27 95%CI 0.12, 0.59 p = 0.001) and a higher initial GCS score (OR 0.79 95%CI 0.73, 0.85 p<0.001) reduced the risk of a severe or fatal course of self-poisoning. Multivariable analysis identified no alcohol co-ingestion (OR 3.23 95%CI 1.3, 8.07 p = 0.012) and self-poisoning with non-medicinal substances (OR 5.4 95%CI 1.78, 16.34 p = 0.003) as factors predictive for “severe” or “fatal” suicide outcome. A higher severity of poisoning positively correlated with duration of inpatient therapy (p<0.001, Spearman’s rho = 0.454) and duration of ventilation (p<0.001, rho = 0.474), and it inversely correlated with initial Glasgow Coma Scale (GCS) score (p<0.001, rho = -0.437). 61 patients (5.6%) had PSS “severe” 14 patients (1.3%) died. PSS was classified in the majority as “minor” (n = 558, 51.2%) or “moderate” (n = 264, 24.2%). Median age was 39 years (range 13–91), 66.7% of patients were female. 1090 patients were included in the study. Multivariable binomial logistic regression analysis was performed to determine predictive factors for severe and/or fatal self-poisoning. Spearman’s rank correlation coefficient was used to test the association of PSS with sociodemographic, anamnestic and (pre-)clinical parameters. Severity of poisoning was assessed on admission and after 24 hours according to the Poison Severity Score index (PSS). All patients underwent at least one psychiatric exploration during their inpatient stay. In this retrospective single-centre study in patients hospitalized due to suicidal poisoning in a specialized clinical toxicology unit, we aimed to identify predictive factors associated with severe or fatal course of self-poisoning. Prediction of clinical course of intoxication is essential for timely initiation of appropriate medical treatment in patients hospitalized due to suicidal self-poisoning.

Christian coma x reader about selfharm