Hospital admissions due to drug overdose

Objective: To study the pattern of drug overdose (types of drugs involved, patient characteristics, acute management and clinical outcome) in patients admitted to the Royal Hobart Hospital, a 500-bed acute-care teaching hospital. Study procedure: A review of admissions due to drug overdose was retrospecively performed. The medical records of 110 patients over 12 years of age who had been admitted to the Royal Hobart Hospital with a drug overdose during the period January 1992 to May 1993 were studied.

Results: Cases of drug overdose represented approximately 0.3% of all hospital admissions during the review period. The median age of the sample was 31 years (range: 14-88 years), and 73 (66%) were females. Almost one-half of the patients (49%) had previously taken an overdose. A total of 261 substances were ingested by the 110 patients; more than one compound had been ingested by 71% of the patients. Benzodiazepines were consumed most frequently (involved in 40% of the cases), followed by tricyclic antidepressants/mianserin (33%), paracetamol (23%), combination analgesics (14%), anticonvulsants (11%) and antipsychotics (9%). Alcohol had been co-ingested in over one-third of the cases (38%). Activated charcoal was the most common form of management, being given to 85% of the patients, with gastric lavage being performed in 70% of all cases. Formal psychiatric consultation was arranged for 93 (85%) patients, with 70 (64%) being diagnosed as having a psychiatric problem. Fifteen patients (14%) required admission to the intensive care unit. None of the patients died or had major complications as a result of drug overdose. The median length of hospitalisation was 2 days (range: 1-26 days).

Conclusions: Drug overdose admissions to the Royal Hobart Hospital frequently involve females aged 40 years or less who have overdosed previously. Alcohol is often implicated. While significant morbidity following admission due to drug overdose is uncommon, the costs associated with hospitalisation are considerable.