• Andreas Christ, Christian A Arranto, Christian Schindler, Theresia Klima, Patrick R Hunziker, Martin Siegemund, Stephan C Marsch, Urs Eriksson, and Christian Mueller.
• Department of Internal Medicine, University of Basel, University Hospital, Petersgraben 4, 4031 Basel, Switzerland.
• Intensive Care Med. 2006 Sep 1;32(9):1423-7.

ObjectiveTo assess the incidence and outcome of clinically significant aspiration pneumonitis in intensive care unit (ICU) overdose patients and to identify its predisposing factors.DesignRetrospective cohort study.SettingMedical ICU of an academic tertiary care hospital.PatientsA total of 273 consecutive overdose admissions.Measurements And ResultsClinically significant aspiration pneumonitis was defined as the occurrence of respiratory dysfunction in a patient with a localised infiltrate on chest X-ray within 72 h of admission. In our cohort we identified 47 patients (17%) with aspiration pneumonitis. Importantly, aspiration pneumonitis was associated with a higher incidence of cardiac arrest (6.4 vs 0.9%; p = 0.037) and an increased duration of both ICU stay and overall hospital stay [respectively: median 1 (interquartile range 1-3) vs 1 (1-2), p = 0.025; and median 2 (1-7) vs 1 (1-3), p < 0.001]. In multivariate logistic regression analysis, Glasgow Coma Scale (GCS) score [odds ratio (OR) for each point of GCS 0.8; 95% confidence interval (CI) 0.7-0.9; p = 0.001], ingestion of opiates (OR 4.5; 95% CI 1.7-11.6; p = 0.002), and white blood cell count (WBC) (OR for each increase in WBC of 10(9)/l 1.05; 95% CI 1.0-1.19; p = 0.049) were identified as independent risk factors.ConclusionsClinically relevant aspiration pneumonitis is a frequent complication in overdose patients admitted to the ICU. Moreover, aspiration pneumonitis is associated with a higher incidence of cardiac arrest and increased ICU and total in-hospital stay.

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