Abstract:
Background Organophosphorus poisoning (OPP) is a prevalent mortality rate that varies from 2% to 25% method of suicides worldwide. ICUs commonly employ various scoring systems such as the Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), and International Programme on Chemical Safety (IPCS) Poison Severity Score (PSS) tools for risk stratification for mortality prediction scores and prognosis. This study aims to compare the predictive validity of these systems in hospitalized patients suffering from pesticide poisoning in a teaching hospital located in central India. Methods A prospective study design was utilized to gather relevant variables for calculating the GCS, APACHE II, SAPS II, and IPCS scales in patients affected by pesticide poisoning. Data on the administered doses of atropine and pralidoxime (PAM) were also recorded. Results We have identified several independent predictors of mortality among patients suffering from pesticide poisoning. The GCS (P=0.001), tracheostomy (P=0.001), APACHE II score (P=0.01), and SAPS II score (P=0.001) were all found to be significant indicators of mortality. Interestingly, the GCS demonstrated comparable predictive ability for mortality when compared to the APACHE II (0.82 (95% confidence interval (CI) 0.70 to 0.94)) and SAPS II (0.83 (95% CI 0.72 to 0.94)) scores, with no statistically significant difference (P=0.75) observed. Among the variables used in the IPCS PSS (GCS, heart rate, systolic blood pressure (BP), intubation, and pupil size), only GCS (P=0.05), and intubation (P=0.01) exhibited a significant association with mortality. Conclusions Our study determined that the GCS score, SAPS II, IPCS PSS, and APACHE II exhibited equal efficacy in predicting mortality. Notably, the GCS offered an added advantage due to its simplicity and minimal time requirements compared to the other scales.
摘要:
背景有机磷中毒(OPP)是一种普遍的死亡率,在全球范围内的自杀方法在2%至25%之间变化。ICU通常采用各种评分系统,例如格拉斯哥昏迷量表(GCS),急性生理学和慢性健康评估II(APACHEII),简化急性生理学评分II(SAPSII),和国际化学品安全计划(IPCS)毒物严重程度评分(PSS)工具,用于死亡率预测评分和预后的风险分层。这项研究旨在比较这些系统在印度中部一家教学医院遭受农药中毒的住院患者中的预测有效性。方法采用前瞻性研究设计收集相关变量来计算GCS,APACHEII,SAPSII,受农药中毒影响的患者的国际化学品安全方案量表。还记录了阿托品和解立肟(PAM)的给药剂量的数据。结果我们已经确定了几个独立的预测农药中毒患者死亡率的因素。GCS(P=0.001),气管造口术(P=0.001),APACHEII评分(P=0.01),和SAPSII评分(P=0.001)均被发现是死亡率的显著指标。有趣的是,与APACHEII(0.82(95%置信区间(CI)0.70至0.94))和SAPSII(0.83(95%CI0.72至0.94))评分相比,GCS对死亡率的预测能力相当,差异无统计学意义(P=0.75)。在IPCSPSS(GCS,心率,收缩压(BP),插管,和瞳孔大小),仅GCS(P=0.05),插管(P=0.01)与死亡率显著相关。结论我们的研究确定GCS评分,SAPSII,IPCSPSS,和APACHEII在预测死亡率方面表现出同等疗效。值得注意的是,GCS提供了一个额外的优势,由于其简单性和最小的时间要求相比,其他规模。