Various Symptoms and Complications Seen in Critically Ill Adult Substance Use Disorders Patients in Intensive Care Unit of a Tertiary Care Hospital: An Observational Study

Abstract

Introduction: Substance use disorders are a common problem all over the world. Substance dependence may be associated with one or more substances at the same time and may include the use of illicit or illegal substances or misuse of legal substances like alcohol, tobacco, and prescription drugs. Common substance use disorders include tobacco products, alcohol, benzodiazepines, opioids, and derivatives. This leads to increased mortality, morbidity, medical interventions, along with hospital stays. Aim: To find the challenges like delirium, withdrawal, and its complications in adult patients with substance use disorders who are critically ill, posed to the treating staff in the critical care unit. Materials and methods: A cross-sectional observational study included 110 adult patients of both sexes, aged between 18 and 60 years, who were dependent on substances like tobacco, alcohol, opioids, and benzodiazepines and needed admission to the intensive care unit (ICU); from 15th February to 15th August 2022. Relevant data on adverse events that occurred due to substance withdrawal, any complications from substance use like local or general infection, and any comorbidity were noted. The Confusion Assessment Method for the ICU (CAM-ICU) scale was used to diagnose delirium. A urine toxicology screen was done. The data were collected, tabulated, and statistically analyzed by descriptive-analytical method. Results: A total of 429 adverse events were noted. The most common adverse event due to substance withdrawal was agitation and delirium (46.39%), followed by inconvenience to other patients in the unit 17.02%, increased requirement of sedation and analgesia (15.11%), increased hospital stay (8.39%), arrhythmias including atrial fibrillation and cardiac myopathy in (4.43%). The younger population was addicted to more than one substance intravenously than the older individuals. Conclusion: The symptoms and complications seen in substance dependents in the ICU increase the morbidity, mortality, hospital stay, number of interventions, and financial burden on a family. These patients not only harm themselves but also harm the treating staff and damage hospital equipment and also disturb other fellow patients.

Keywords

• critical care unit
• delirium
• substance withdrawal
• withdrawal complications