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

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

Resumen: 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.

Idioma: Inglés

DOI: 10.1186/s13054-024-05096-7

Año: 2024

Publicado en: Critical care 28 (2024), 316 [14 pp.]
ISSN: 1364-8535

Factor impacto JCR: 9.3 (2024)

Categ. JCR: CRITICAL CARE MEDICINE rank: 4 / 62 = 0.065 (2024) - Q1 - T1

Factor impacto SCIMAGO: 2.738 - Critical Care and Intensive Care Medicine (Q1)

Tipo y forma: Article (Published version)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)