Comparison of different scores as predictors of mechanical ventilation in drug overdose patients

El-Sarnagawy, Ghada N; Hafez, Amal

doi:10.1177/0960327116655389

Cited by 16 publications

(11 citation statements)

References 33 publications

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“…In the current study, REMS was good predictor for requirement of mechanical ventilation at cut off value > 4. This matches with (Olsson and Lind, 2003), (Goodacre, Turner and Nicholl, 2006), (El-Sarnagawy andHafez, 2017) &(Abd Elghany et al, 2018) who supposed REMS as a valuable scoring system that tends to be a good predictor of morbidity and duration of hospitalization in patients admitted to the Emergency department (ED).…”

Section: Discussionsupporting

confidence: 75%

Evaluation of Various Scoring Systems in Prediction of Acute Carbon Monoxide Poisoning Outcome

2022

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Background: Carbon monoxide (CO) poisoning is one of the most common fatal poisoning worldwide. Laboratory parameters and imaging studies have been used to predict late cardiac and neurological complications in CO poisoned patients. However, very few studies have applied scoring systems as predictors of CO poisoning outcome. Objectives: To evaluate various scoring systems used in emergency settings [Rapid Emergency Medicine Score (REMS), Modified Early Warning Score (MEWS) and Simple Clinical Score (SCS)] for outcome prediction in acute CO poisoned patients. Methodology: It was a cross-sectional study that was conducted on forty five acute CO poisoned patients. It was composed of two parts; retrospective (From 1 st of January 2020 to 28 th of February 2021) and prospective part (From 1 st of March 2021 to 30 th of June 2021). Patients with major medical conditions, pregnant females, smokers and those exposed to associated trauma and other substances in addition to CO were excluded. Using patients' data on admission, REMS, MEWS and SCS were calculated and compared for prediction of outcome. Results: On admission REMS, MEWS and SCS showed significant elevation in both mechanically ventilated and non-survivors when compared to nonmechanically ventilated patients and survivors. MEWS was excellent predictor for requirement of mechanical ventilation (AUC > 0.9). For mortality prediction; REMS, MEWS and SCS were all excellent (AUC = 1). Conclusion: REMS, MEWS and SCS are simple, rapid, reliable and applicable scoring system in predicting mechanical ventilation requirement and in-hospital mortality in acute CO poisoning.

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Section: Discussionsupporting

confidence: 75%

Evaluation of Various Scoring Systems in Prediction of Acute Carbon Monoxide Poisoning Outcome

2022

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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“…Furthermore, Maignan et al 52 verified that GCS was the only clinical parameter associated with ICU admission in patients with deliberate drug poisoning who presented with slight symptoms on admission. El‐Sarnagawy and Hafez 53 also identified GCS of ≤8 on admission as the most sensitive (100%) predictor for mechanical ventilation in drug‐overdosed patients. Moreover, many studies demonstrated the prognostic value of the GCS, heart rate, SBP, and respiratory rate in predicting outcomes of the ICU admitted poisoned patients 16,29,54 …”

Section: Discussionmentioning

confidence: 97%

Development of a risk prediction nomogram for disposition of acute toxic exposure patients to intensive care unit

Elgazzar

Afifi

Shama

et al. 2021

Basic Clin Pharma Tox

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Early risk stratification of acutely poisoned patients is essential to identify patients at high risk of intensive care unit (ICU) admission. We aimed to develop a prognostic model and risk‐stratification nomogram based on the readily accessible clinical and laboratory predictors on admission for the probability of ICU admission in acutely poisoned patients. This retrospective cohort study included adult patients with acute toxic exposure to a drug or a chemical substance. Patients' demographic, toxicologic, clinical and laboratory data were collected. Among the 1260 eligible patients, 180 (14.3%) were admitted to the ICU. We developed a generalized prognostic model for predicting ICU admission in patients with acute poisoning. The predictors included the Glasgow coma scale, oxygen saturation, diastolic blood pressure, respiratory rate and blood bicarbonate concentration. The model displayed excellent discrimination and calibration (optimistic‐adjusted area under the curve = 0.924 and optimistic‐adjusted Hosmer and Lemeshow test = 0.922, respectively) when internally validated. Additionally, we developed prognostic models that determine ICU admission in patients with specific poisonings. Furthermore, we constructed risk‐stratification nomograms that rank the probability of ICU admission in these patients. The developed risk‐stratification nomograms help decision‐making regarding ICU admission in acute poisonings. Future external validation in independent cohorts is necessary before clinical application.

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“…The three studied scores were evaluated as predictors of the need for ICU admission and/ or MV in different poisoning cases but not TCAs. El-Sarnagawy and Hafez (2017) and Shahin and Hafez (2020) found that APACHE II score and REMS were good predictors for the need of MV in overdosed cases with disturbed consciousness and in cases with anticholinesterase inhibitors (AChEIs) poisoning. Abd Elnoor et al (2019) concluded that PSS and APACHE II score are good predictors for the need of ICU admission in aluminum phosphide and digitalis poisoning cases.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Effectiveness of Three Scoring Systems in Outcome Prediction of Acute Tricyclic Antidepressants Poisoning Cases

Wahdan

Helal

2021

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Background: Tricyclic antidepressants (TCAs) toxicity continues to be a major problem and an important cause of morbidity and mortality from poisoning all over the world. Aim of the study: to compare the effectiveness of poison severity score (PSS), acute physiology and chronic health evaluation (APACHE II) score and rapid emergency medicine score (REMS) for prediction of the need for intensive care unit (ICU) admission and mechanical ventilation (MV) in cases with acute TCAs toxicity. Methods: This retrospective observational study was conducted on 109 TCAs poisoned cases who were admitted to Tanta University Poison Control Center during the period from the first of January 2017 to the end of December 2020. Three scoring systems (PSS, APACHE II and REMS) were calculated for all cases at admission. Discrimination was evaluated using receiver operating characteristics curve and calculating the area under the curve (AUC). Results: The results of this study revealed that twenty-five cases needed to be admitted to ICU and 8 cases needed MV. The median of the three scores was significantly higher in cases that needed both ICU admission and MV. Although the APACHE II score has the best AUC value for prediction of ICU admission and MV (0.956 and 0.943 respectively), there was no statistically significant difference between the three scores. The AUC value of REMS comes next (0.931 and 0.925 respectively). Conclusion: REMS is rapid and simple score that can be easily assessed in emergency situations, it is recommended to be used for outcome prediction in TCAs poisoning.

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Comparison of different scores as predictors of mechanical ventilation in drug overdose patients

Cited by 16 publications

References 33 publications

Evaluation of Various Scoring Systems in Prediction of Acute Carbon Monoxide Poisoning Outcome

Evaluation of Various Scoring Systems in Prediction of Acute Carbon Monoxide Poisoning Outcome

Development of a risk prediction nomogram for disposition of acute toxic exposure patients to intensive care unit

Comparing the Effectiveness of Three Scoring Systems in Outcome Prediction of Acute Tricyclic Antidepressants Poisoning Cases

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