Comparing Sequential Organ Failure Assessment Score, Acute Physiology and Chronic Health Evaluation II, Modified Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II and Poisoning Severity Score for Outcome Prediction of Pesticide Poisoned Patients Admitted to the Intensive Care Unit.

IF 0.8 Q4 PHARMACOLOGY & PHARMACY Journal of Research in Pharmacy Practice Pub Date : 2024-01-31 eCollection Date: 2023-04-01 DOI:10.4103/jrpp.jrpp_43_23

Gholamali Dorooshi, Shiva Samsamshariat, Farzad Gheshlaghi, Shafeajafar Zoofaghari, Akbar Hasanzadeh, Saeed Abbasi, Nastaran Eizadi-Mood

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Abstract

Objective: This study aimed to assess the severity of poisoning, various scoring systems, including Sequential Organ Failure Assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II), Simplified Acute Physiology Score (SAPS II), Modified APACHE II, and poisoning severity score (PSS) were used. In this study, we compared the predictive value of these scoring systems on the outcome of pesticide-poisoned patients.

Methods: This is a cross-sectional study of pesticide-poisoned patients (140 patients) who were admitted to the intensive care unit (ICU) of Khorshid Hospital, Isfahan, Iran, between January 2015 and 2019. The area under the receiver operating characteristic (AUC) curve and the predictive value of scoring systems were compared.

Findings: Poisoning was higher in the male population (72.8%). The causes of poisoning were paraquat, (38.6%), aluminum phosphide, (32.1%), and organophosphate, (29.3%). The mean age of the patients was 33.9 years. Most patients (79.3%) attempted suicide. The mortality rate was 46.43%. The mean of "SOFA score," "APACHE II," "SAPS II," "Modified APACHE II," and "PSS" was 5.9; 15.7; 30.02; 15.8; and 1.9, respectively. There was a significant difference in the mean of all scoring systems for outcome prediction. Among all scoring systems, the SAPS II score with the cutoff point (16.5) had the best criteria for outcome prediction (AUC (0.831 ± 0.037), sensitivity (83.1%, 95% confidence interval [CI]: [71.7-91.2]), specificity (75.7%, 95% CI: [64.3-84.9]), positive predictive values (75.0%, 95% CI: [66.4-82.0]), negative predictive values (83.6%, 95% CI: [74.5-89.9]).

Conclusion: The SAPS II scoring system may be a suitable indicator for outcome predictions in pesticide-poisoned patients in the ICU.

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比较顺序器官衰竭评估评分、急性生理学和慢性健康评估 II、改良急性生理学和慢性健康评估 II、简化急性生理学评分 II 和中毒严重程度评分，以预测入住重症监护室的农药中毒患者的预后。

研究目的本研究旨在评估中毒的严重程度，使用了多种评分系统，包括序贯器官衰竭评估（SOFA）评分、急性生理学和慢性健康评估 II（APACHE II）、简化急性生理学评分（SAPS II）、改良 APACHE II 和中毒严重程度评分（PSS）。在本研究中，我们比较了这些评分系统对农药中毒患者预后的预测价值：这是一项横断面研究，研究对象为 2015 年 1 月至 2019 年期间入住伊朗伊斯法罕 Khorshid 医院重症监护室（ICU）的农药中毒患者（140 名）。比较了接受者操作特征曲线下面积（AUC）和评分系统的预测价值：男性中毒率较高（72.8%）。中毒原因为百草枯（38.6%）、磷化铝（32.1%）和有机磷（29.3%）。患者的平均年龄为 33.9 岁。大多数患者（79.3%）试图自杀。死亡率为 46.43%。SOFA 评分"、"APACHE II"、"SAPS II"、"改良 APACHE II "和 "PSS "的平均值分别为 5.9、15.7、30.02、15.8 和 1.9。所有评分系统对结果预测的平均值均有明显差异。在所有评分系统中，以 16.5 为分界点的 SAPS II 评分具有最佳的结果预测标准（AUC（0.831 ± 0.037）、灵敏度（83.1%，95% 置信区间 [CI]：[71.7-91.2]）、特异性（75.7%，95% CI：[64.3-84.9]）、阳性预测值（75.0%，95% CI：[66.4-82.0]）、阴性预测值（83.6%，95% CI：[74.5-89.9]）：SAPSⅡ评分系统可能是预测重症监护室农药中毒患者预后的合适指标。

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Journal of Research in Pharmacy Practice PHARMACOLOGY & PHARMACY-

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审稿时长

21 weeks

期刊介绍： The main focus of the journal will be on evidence-based drug-related medical researches (with clinical pharmacists’ intervention or documentation), particularly in the Eastern Mediterranean region. However, a wide range of closely related issues will be also covered. These will include clinical studies in the field of pharmaceutical care, reporting adverse drug reactions and human medical toxicology, pharmaco-epidemiology and toxico-epidemiology (poisoning epidemiology), social aspects of pharmacy practice, pharmacy education and economic evaluations of treatment protocols (e.g. cost-effectiveness studies). Local reports of medication utilization studies at hospital or pharmacy levels will only be considered for peer-review process only if they have a new and useful message for the international pharmacy practice professionals and readers.