Predicting outcomes in organophosphate poisoning based on APACHE II and modified APACHE II scores.
The aim of this study was to evaluate the scores of the Acute Physiology and Chronic Health Evaluation (APACHE) II and a modified APACHE II system (MAS), without parameters of biochemical tests; and to find prognostic value of individual elements of the APACHE II and MAS in predicting outcomes in organophosphate (OP) poisoning. Data were collected from 131 patients. The median (25th-75th percentiles) of APACHE II score for survivors without intubation were found to be lower than those of non survivors or survivors with intubation and ventilation, [4 (1-7); versus 17.5 (7.8-29), and 13.5 (7.8-16.3)]. Logistic regression analysis identified white blood cell (WBC), potassium, Glasgow coma scale (GCS), age and sodium in APACHE II; GCS and mean arterial pressure in MAS system as prognostically valuable. There was no statistically significance difference between APACHE II and MAS scores in terms of area under Receiver Operating Characteristic Curve [(0.902, 95% confidence interval: (0.837-0.947) for APACHE II), and (0.892, 95% confidence interval: (0.826-0.940) for MAS); P=0.74) to predict need for intubation. It is concluded usage of MAS facilitates the prognostication of the OP poisoned patients due to simplicity, less time-consuming and effectiveness in an emergency situation.
Eizadi-Mood
N
N
Anesthesiology and Intensive Care Department, Isfahan University of Medical Sciences, and Department of Poisoning Emergency, Noor and Ali Asghar Hospital, Isfahan, Iran. izadi@med.mui.ac.ir
Saghaei
M
M
Jabalameli
M
M
D018806:APACHE; D000328:Adult; D001794:Blood Pressure; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D007442:Intubation, Intratracheal; D007492:Iran / Q000453:epidemiology; D007902:Length of Stay; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D062025:Organophosphate Poisoning; D011041:Poisoning / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D011188:Potassium / Q000097:blood; D011379:Prognosis; D012372:ROC Curve; D012121:Respiration, Artificial; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood
D012964:Sodium; D011188:Potassium