Validity of Vital Signs, Coma Scales and Modified APACHE Score in Prediction of Prognosis and Outcome of Acutely Poisoned Patients

Abstract

Introduction: Acute toxicity management is a major medical problem in the whole world as poisoning is one of the most common causes for coming to hospital emergency departments. Early diagnosis and treatment in emergency department and ICU are critical for the poisoned patient to reduce hospital morbidity and mortality.
Objective: Evaluation of the validity of coma scaling systems as Glasgow coma scale (GCS), Reed scale, poisoning severity score (PSS), modified acute physiology and chronic health evaluation (APACHE) score (MAS) and vital signs as predictors of clinical course and outcome of acutely poisoned patients.
Patients and Methods: This retrospective study was carried out on 100 acutely intoxicated patients. They were selected from patients attended Sohag University Hospitals with age more than 18 years old who were in need for intermediate or intensive care unit. The study was conducted during the period from March 2018 to the end of February 2021. Results: this study revealed that 62% of the patients were in the age group 18-30 years old and 63% were females. The majority of them intoxicated by oral route (91%) and most of them were suicidal (68%). For the  outcome, 75% of patients had been survived and 25% of patients died. PSS, Reed, MAS and GCS as coma scaling scores at admission showed significant difference between survivors and non-survivors of these patients. Systole and diastole as parameters of vital signs also showed significant difference between survivors and non-survivors. While, pulse, temperature and respiratory rate showed non-significant difference between survivors and non-survivors.
Conclusion: The study concluded that PSS, Reed scale, MAS, GCS, diastole and systole respectively are valid prognostic tools for the outcome in acutely poisoned patients.