Clinical and Laboratory Predictors of Acute Poisoning Mortality among Intensive Care Unit Patients, With Special Consideration to New-Poisoning Mortality Score | ||||
| Zagazig Journal of Forensic Medicine and Toxicology | ||||
| Article 5, Volume 22, Issue 2, July 2024, Page 114-136 PDF (509.76 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zjfm.2024.291628.1188 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Hend M. Ahmed   1; Hend Gamal Aref2
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| 1Department of forensic medicine and clinical toxicology, Faculty of Medicine, Sohag University, Sohag ,Egypt | ||||
| 2Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Sohag University, Sohag , Egypt | ||||
| Abstract | ||||
| Background: Emergency department visits for acute poisoning are increasing and often need intensive care unit (ICU) treatment. Prompt severity evaluation and appropriate treatment can minimize poisoning patients' mortality and morbidity. Aim: Evaluating the role of clinical and laboratory characteristics of acute poisoning patients admitted to ICU in predicting mortality with special consideration to new poisoning mortality score. Patients and Methods: A cross-sectional study was conducted on ninety acute intoxication patients aged 18 years old and above of both sexes, admitted to ICU in Sohag University Hospitals. Demographic, toxicological data, vital signs, GCS, New-poisoning mortality score (NPMS), poisoning severity score (PPS), laboratory investigations such as arterial blood gases, liver and kidney functions, and CBC were recorded and related to the patient's outcome. Results: Results showed that 62.22% of patients were in the 20-40 age range, females were 61.11% and suicide rate was 82.22%. Aluminum phosphide, organophosphorus, and antipsychotics were the most common toxic agents in the study. The mortality was 33.33%. Regarding the clinical and laboratory characteristics, systolic and diastolic blood pressure, oxygen saturation, need for mechanical ventilation, PH, HCO3, Na, Ca, ALT, AST, creatinine, WBCs, and platelets counts showed a significant difference between survivors and non-survivors. The cutoff points for mortality prediction by new-PMS, PSS, and GCS were ≥ 56, ≥ 2, and < 8 with a sensitivity of 88.33% for all, specificities of 80 %, 96.67%, and.70 %, and accuracy of 89.8%, 92.6%, and 81.6% respectively. Conclusion: Using toxicological data, routine laboratory analysis, vital signs, and GCS on admission can predict acutely poisoned patients’ outcomes. Recommendations: It is critical to raise public knowledge about the dangers of aluminum phosphide and organophosphorus poisons, as these were the most prevalent hazardous compounds studied. The new poisoning mortality score is a simple, quick, and simply applied technique for predicting acute poisoning mortality | ||||
| Keywords | ||||
| Prediction; Mortality; Scoring systems; New- PMS; Intensive Care Unit | ||||
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