Retrospective five-year analysis of treatments applied to poisoning cases admitted to the anesthesiology and reanimation intensive care unit

Introduction and Objective: Poisonings are significant public health issues today. With the advancement of technology, the number and variety of chemical substances have increased, raising the likelihood of human exposure and leading to a growing frequency of poisoning cases, particularly in developed countries. This study aims to analyze poisoning cases in the Intensive Care Unit of the Department of Anesthesiology and Reanimation at Karadeniz Technical University Faculty of Medicine, examining patient profiles, causes of poisoning, and the effects of treatment methods on mortality. Materials and Methods: This study was conducted retrospectively by screening the data of patients aged 18 years and older who were admitted to the Intensive Care Unit of the Department of Anesthesiology and Reanimation at Karadeniz Technical University Faculty of Medicine due to poisoning, were followed up for at least 24 hours, and had sufficient available data between January 1, 2019, and January 1, 2024. Demographic data of the cases (gender, age, height, weight, BMI), the cause of poisoning, whether it was intentional (suicide-related), the time of admission to intensive care after poisoning, duration of stay in the intensive care unit, and the presence of comorbid systemic diseases were recorded. Vital signs, laboratory tests, GCS, APACHE-II, SOFA, SAPS-II, and PSS scores at admission were documented. The predictive power of these scoring systems for mortality was analyzed. Treatments administered during intensive care follow-up were also recorded. Patients were categorized into two groups: those who died (Ex) and those who survived, and the collected data were compared between the two groups. Results: When the 49 patients included in the study were evaluated regarding the substances they were exposed to, the most common causes were drug and alcohol intake. The types of drugs leading to poisoning were predominantly antipsychotics, antidepressants, and cardiovascular system drugs. Twenty patients were admitted to intensive care due to suicide-related poisoning. Among the scoring systems, the GCS score was significantly lower in the deceased group compared to the surviving group, while APACHE-II, SOFA, SAPS-II, and PSS scores were significantly higher (p<0.05). In the deceased group, the use of vasopressors, invasive mechanical ventilation, CRRT, ECMO, plasmapheresis, and antidotes was significantly higher than in the surviving group. The rate of gastrointestinal (GI) lavage was significantly lower in the deceased group (p<0.05). Conclusion: The GCS, SOFA, APACHE-II, SAPS-II, and PSS scoring systems used in this study can be utilized to predict mortality in the clinical course of this patient group in intensive care. However, further studies are needed in larger and more homogenous patient groups to obtain more reliable results in this field. While treatment methods are specific to each patient and type of poisoning, supportive therapy combined with GI lavage was found to reduce mortality in this study. Keywords: Intensive care, poisoning, scoring systems, mortality