# Critical care utilization associated with an electronic dance music festival in Las Vegas, Nevada: A retrospective cohort study of the electric daisy carnival

## TL;DR

This study found that patients who overdosed at an electronic dance music festival were more likely to be admitted to the ICU compared to those with non-festival-related overdoses.

## Contribution

The study provides new evidence on the disproportionate critical care utilization linked to EDM festivals compared to non-festival-related overdoses.

## Key findings

- EDC-related patients had a significantly higher ICU admission rate compared to non-EDC patients.
- Clinical severity scores and mortality were similar between EDC and non-EDC groups.
- Age and EDC status were significant predictors of ICU admission.

## Abstract

Electronic dance music (EDM) festivals are associated with recreational drug use and medical emergencies, yet comparative data on the severity of festival-related overdoses are limited. This study compared hospital outcomes, particularly critical care utilization, between patients transported from the Electric Daisy Carnival (EDC) and those with non–festival-related overdoses during the same period.

We conducted a retrospective cohort study of adults (≥18 years) presenting with drug or alcohol overdose to an urban tertiary care teaching hospital between May 17, 2019, and May 20, 2024. Patients were classified as EDC-related or non-EDC based on electronic medical record documentation. Group differences were assessed using chi-square and independent t-tests. Logistic regression evaluated predictors of intensive care unit (ICU) admission.

Of 1127 hospital admissions, 103 met eligibility criteria; 40 (38.80%) were EDC-related and 63 (61.20%) were non-EDC. EDC-related patients were younger (32.40 ± 8.50 vs. 44.30 ± 11.60 years, p < 0.001) but did not differ significantly from non-EDC patients in sex distribution, drug use patterns, Sequential Organ Failure Assessment (SOFA) scores, or QT intervals. ICU admission was higher among EDC-related patients compared with non-EDC patients (77.50% vs. 44.40%, p < 0.001). No significant differences were observed in total hospital length of stay, ICU length of stay, or mortality between groups. Logistic regression showed age and EDC status as the significant predictors of ICU admission.BMI demonstrated a borderline association whereas sex, QT interval, were not independently associated with ICU admission.

EDC-related overdose patients had markedly higher likelihood of ICU admission compared with non-EDC overdose patients, despite similar clinical characteristics on presentation. The findings highlight the disproportionate resource burden associated with EDM festivals and underscore the need for enhanced harm-reduction strategies, improved on-site medical triage, and proactive planning by local hospitals and emergency services.

•Mass gatherings increase demand for critical care services.•Festival-related overdose patients were admitted to intensive care more often.•Clinical severity scores were similar between groups.•Intensive care admission estimated resource utilization.•Large music festivals strain local hospital capacity.

Mass gatherings increase demand for critical care services.

Festival-related overdose patients were admitted to intensive care more often.

Clinical severity scores were similar between groups.

Intensive care admission estimated resource utilization.

Large music festivals strain local hospital capacity.