The INTOXICATE study: methodology and preliminary results of a prospective observational study

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2024年9月27日

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Samanta M. Zwaag,
Irma S. van den Hengel-Koot,
Stuart Baker,
Patrick Druwé,
Muhammed Elhadi,
Ana Ferrer Dufol,
Sune Forsberg,
Burcin Halacli,
Christian Jung,
Gabija Laubner Sakalauskienė,
Elin Lindqvist,
Rui Moreno,
Christian Rabe,
Nanna Reiter,
Richard Rezar,
Radu Țincu,
Arzu Topeli,
David M. Wood,
Dylan W. de Lange,
Claudine C. Hunault,
Christian Aage Wamberg,
Hazim Ababneh,
Eman Abdulwahed,
Sefanja Achterberg,
Entisar Ahmed Ali Alshareea,
Aiman Ahmed Hamed,
Mahmoud Alali,
Ali Najeh Al-Awwady,
Amar Al-Jarrah,
Maytham A. Al-Juaifari,
Hazem Zuhair Hussain Alnatour,
Khayry Al-Shami,
Ahmed Altobal,
Shimaa Ahmed Hamed Al-Touny,
Mahmut Arslan,
Theodoros Aslanidis,
Avinash Aujayeb,
Munire Babayigit,
Robertas Badaras,
Stuart Baker,
Patricia Barral Segade,
Najat Ben Hasan,
Dennis C. J. J. Bergmans,
Yeliz Bilir,
Muhannud Binnawara,
Patrick Biston,
Dirk P. Boer,
Hans Christian Boesen,
Hella F. Borggreve,
Helene Brix,
Thirsa Brommer,
Nestor Bueno-Vidales,
Isabel Canas-Pérez,
Maxim P. Carlier,
Alba Castellanos Esparraguera,
Deniz Cekic,
Mario Chico-Fernández,
Lisbeth Christiansen,
Cristian Cobilinschi,
Luis Coelho,
Catalin Constantinescu,
Alexander D. Cornet,
Elena Crescioli,
Cristina Cuenca-Rubio,
Paul I. Dargan,
Raluca Darie,
Dylan W. de Lange,
Francisco de Paula Delgado-Moya,
Nicolas De Schryver,
Bram Dewulf,
Willem Dieperink,
Patrick Druwé,
Simon Dubler,
Maree Duroux,
Mohamed Elbahnasawy,
Muhammed Elhadi,
Ahmet Eroglu,
Selin Eyüpoğlu,
Raquel Feria Gil,
Ana Silva Fernandes,
Carolina Ferrer,
Ana Ferrer Dufol,
Sune Forsberg,
Diego Franch-Llasat,
Rik T. Gerritsen,
Reem Ghmagh,
Juliana Gonzalez Londoño,
Christoffer Grant Sølling,
Kjeld Gravgaard,
Massimiliano Greco,
Goncalo Guerreiro,
Nicole Gustavsson,
Seda Güzeldag,
Burcin Halacli,
Hytham K. S. Hamid,
Philippe Hantson,
Thijs T. W. van Herpt,
Jantine van Holten,
Femke van der Horst,
Aletta P. I. Houwink,
Claudine C. Hunault,
Malene Hvass Renner Block,
Christian Jung,
Stavri Karasiali,
Mohamed Karghul,
Ebru Kaya,
Almu’atasim Khamees,
Justin Koh,
Matty Koopmans,
Vedran Kovacic,
Gabija Laubner Sakalauskienė,
Lenneke E. M. van Lelyveld-Haas,
Elin Lindqvist,
Meritxell Lladó Vilar,
Mette Lolk,
Beatriz Martín-Pérez,
Eva Maria Mateo Rodríguez,
Hélène P. Mattijsen,
Ayman Meelad,
Iris Miltenburg,
Ahmed Ibrahim Mohamed Mohamed,
Rui Moreno,
Marwa Morgom,
Mercedes Mucia-Anayaa,
Khalid Mahmood Khan Nafees,
Mohamed Nassredin,
Binti Haji Abd Rashid Nurhikmahtul Aqilah,
Huub L. A. van den Oever,
Evelien A. N. Oostdijk,
Ozlem Ozkan Kuscu,
Catarina Pacheco,
Dorte Palmqvist,
Despoina Papachristou,
David Pérez-Torres,
Cristina Petrişor,
Michael Piagnerelli,
Wouter Pijper,
Christian Rabe,
Radu Țincu,
Megan Ratcliffe,
Nanna Reiter,
Richard Rezar,
Ferran Roche-Campo,
Emilio Rodriguez-Ruiz,
Harm Roetert,
Jessica Ruiz-Izquierdo,
Ana Maria Ruiz Mena,
Vusala Rzayeva,
Nick van Sabben,
Elfayadh Saidahmed,
Gustaf Sandström,
Kemal Tolga Saracoglu,
Clemens Seelmaier,
Nicolas Serck,
Carlos Serón-Arbeloa,
Susanne Stads,
Louise Stenbryggen Herløv,
Ayca Sultan Sahin,
Josefine Thomsen,
Arzu Topeli,
Yen Tran,
Bas van den Bogaard,
Irma S. van den Hengel-Koot,
Klaas Vanderbiest,
Liam van Dielen,
Abram L. van Duijn,
Jolien Van Hecke,
Klaus Vennick Marcussen,
Marie Vergotten,
Wytze Vermeijden,
Ester Viktorsdottir,
Peter H. J. van der Voort,
Evert-Jan Wils,
Xavier Wittebole,
Esther Wolthuis,
David M. Wood,
Max Wretman,
Hana B. Yahya,
Cengizhan Yavuz,
Selcuk Yaylaci,
Begoña Zalba Etayo,
Samanta M. Zwaag

摘要

Background

There is currently no practice-based, multicenter database of poisoned patients admitted to intensive care units (ICUs). The INTOXICATE study, endorsed by the ESICM and EAPCCT, aimed to determine the rate of eventful admissions among acutely intoxicated adult ICU patients.

Methods

Ethical approval was obtained for this multicenter, prospective observational study, and data-sharing agreements were signed with each participating center. An electronic case report form was used to collect data on patient demographics, exposure, clinical characteristics, investigations, treatment, and in-hospital mortality data. The primary outcome, ‘eventful admission’, was a composite outcome defined as the rate of patients who received any of the following treatments in the first 24 h after the ICU admission: oxygen supplementation with a FiO2 > 40%, mechanical ventilation, vasopressors, renal replacement therapy (RRT), cardiopulmonary resuscitation, antidotes, active cooling, fluid resuscitation (> 1.5 L of intravenous fluid of any kind), sedation, or who died in the hospital.

Results

Seventy-eight ICUs, mainly from Europe, but also from Australia and the Eastern Mediterranean, participated. A total of 2,273 patients were enrolled between November 2020 and June 2023. The median age of the patients was 41 years, 72% were exposed to intoxicating drugs. The observed rate of patients with an eventful ICU admission was 68% (n = 1546/2273 patients). The hospital mortality was 4.5% (n = 103/2273).

Conclusions

The vast majority of patients survive, and approximately one third of patients do not receive any ICU-specific interventions after admission in an intensive care unit for acute intoxication. High-quality detailed clinical data have been collected from a large cohort of acutely intoxicated ICU patients, providing information on the pattern of severe acute poisoning requiring intensive care admission and the outcomes of these patients.

Trial registration: OSF registration ID: osf.io/7e5uy.