# Should Every Symptomatic Patient with Mushroom Poisoning Be Monitored in the Intensive Care Unit?—A Retrospective Observational Study

## TL;DR

This study examines whether all mushroom poisoning patients need intensive care, finding that only those at risk of liver failure require ICU monitoring.

## Contribution

The study suggests that ICU admission should be reserved for patients at risk of acute liver failure rather than all symptomatic cases.

## Key findings

- 7% of patients developed acute liver failure.
- Mortality rate was 5.6% with two patients undergoing liver transplantation.
- Significant improvement in liver and kidney function markers was observed during ICU stay.

## Abstract

A rapid method for the early diagnosis of fatal mushroom poisoning is not available. Therefore, in our region, symptomatic patients are admitted to intensive care units (ICUs) for close monitoring and treatment. This retrospective study evaluated ICU patients with mushroom poisoning to assess clinical and laboratory trends, treatment characteristics, and outcomes and determine the necessity of level 3 ICU admission. Fifty-four patients were included in this study, and the duration of ICU stay was 5.5 ± 3.9 days. Acute liver failure (ALF) was observed in 7% of patients. Eight patients (14.8%) only received symptomatic treatment, whereas two patients underwent liver transplantation, and one of whom died. The overall mortality rate was 5.6%. A significant decrease was observed in alanine aminotransferase, aspartate aminotransferase, bilirubin, urea, creatinine, lactate dehydrogenase, international normalized ratio, and prothrombin time values on the day of discharge from the ICU compared with the day of admission (p < 0.05). Mushroom poisoning cases thought to be at risk of developing ALF can be transferred to transplant centers early to avoid wasting time. However, to ensure that ICU resources are used effectively, we believe that monitoring and treatment in a level 3 ICU should be reserved for patients progressing to liver failure rather than all symptomatic patients.