Clinical Profile and Outcome of Drug Abuse Patients Admitted in Intensive Care Unit of a Tertiary Care Hospital in Kashmir: A Prospective Observational Study

Abstract

Introduction: Drug abuse is a global public health issue that poses significant challenges to healthcare systems particularly in intensive care units (ICU). This study aims to assess the clinical profile and outcomes of drug abuse patients admitted to ICU of a tertiary care hospital in North India.Methods: A prospective observational study was conducted over period of 3 years involving drug abuse patients admitted to the ICU. Demographic data, clinical characteristics, substance abuse patterns, co-morbidities, severity scores and outcomes were recorded.Results: A total of 35 patients were included in the study. All patients were males with a mean age of 29.1(± 11.68).25 patients were from rural areas. 42.8% were unemployed. Most of the patients (85.7%) were unmarried. 34.3% were students. Mean APACHE II score on ICU admission was 13. Most of patients were admitted for heroin overdose (60%). All 35 patients admitted in ICU had low Glasgow coma scale (GCS< 7). 32 (91.4%) patients had associated respiratory failure. 7 patients had cardiovascular instability. 4 (11.4%) patients developed multi-organ failure during the ICU stay. Mean duration of ICU stay was 3.4 (± 2.68). 23 (65.7%) patients got extubated within 24 hours of ICU admission. 4 patients expired (11.4% mortality) in study group. Sepsis was cause of death in one patient, 3 patients died of multi-organ failureConclusion: Most of the overdose was due to opioids specifically of heroin. CNS depression was found in all drug overdose patients followed by respiratory failure. Multi organ involvement have poor outcome. Mortality ensued in 11.4% of admitted patients as a result of sepsis and multi-organ failure. Majority of the patients had good outcome especially patients who presented early to healthcare facility.