A Prospective Study of Poisoning Severity Score among Acute Antipsychotic Poisoned Cases Admitted to Menoufia Poison Control Center (MPCC) Throughout One Year

Hammad, Samy; Girgis, Naira F; Amin, Safaa; Zanaty, Azza; Hatab, Haidy Abou

doi:10.21608/ajfm.2015.18657

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…This could be explained by that schizophrenic patient usually attempt suicide by taking high doses of drugs that they can easily access. Thus, acute poisoning with one of the antipsychotics drugs may be expected among these patients (Hammad et al, 2016).…”

Section: Resultsmentioning

confidence: 99%

Risk Factors for the Need of Intensive Care Unit Admission Among Acute Clozapine Poisoned Patients: A Retrospective Cohort Study

Wahdan

Sharkawy

Afandy

et al. 2022

The Egyptian Journal of Forensic Sciences and Applied Toxicolog

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Introduction: Clozapine is the most effective antipsychotic drug for the treatment of refractory schizophrenia. It is also seen as the most toxic in its class. Drug poisoning has been detected as one of the major causes of intensive care unit (ICU) admission. The study aimed to develop a decision tool using readily available parameters in the emergency room for patients with acute clozapine poisoning to identify patients who need ICU admission. Patients and Methods: This retrospective cohort study was carried out on 121 patients with acute clozapine poisoning admitted to the Tanta University Poison Control Center. For each patient, demographic, toxicological, clinical data, laboratory findings, and electrocardiography records were analyzed against ICU admission. Results: The results revealed that 29 patients needed ICU admission, and they were significantly older than patients who did not. A significant association was found between the history of addiction and/or psychiatric illness, mode of poisoning, amount and dose of clozapine, and the need for ICU admission. Patients admitted to ICU had a significantly higher percentage of tachycardia, tachypnea, and hyperthermia, while they had a lower Glasgow Coma Scale (GCS) and oxygen saturation. Besides, they had a significantly higher percentage of hyperglycemia, respiratory alkalosis, and prolonged QTc interval. There was a significant association between the need for ICU admission and both electrocardiogram (ECG) severity grading and acute clozapine poisoning severity score. The logistic regression model showed that large doses of clozapine, tachypnea, increased the severity of ECG grading, and decreased level of O2 saturation on admission significantly increased the probability of requiring ICU admission. Based on receiver operating characteristic curve analysis, take a dose of clozapine at a cut-off value above 250 mg is a good predictor of the need for ICU admission. Conclusion: It could be concluded that higher taken doses of clozapine, tachypnea, low O2 saturation, and increased severity of ECG grading are considered independent predictors of the need for ICU admission in acute clozapine poisoned patients.

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Section: Resultsmentioning

confidence: 99%

Risk Factors for the Need of Intensive Care Unit Admission Among Acute Clozapine Poisoned Patients: A Retrospective Cohort Study

Wahdan

Sharkawy

Afandy

et al. 2022

The Egyptian Journal of Forensic Sciences and Applied Toxicolog

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A nomogram proposal for early prediction of intensive care unit admission in patients with acute antipsychotic poisoning

El-Gharbawy,

Kabbash,

Ghonem

2023

Toxicology Research

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Background Early identification of antipsychotic poisoned patients who may have a potential risk for intensive care unit (ICU) admission is crucial especially when resources are limited. Nomograms were previously used as a practical tool to predict prognosis and planning the treatment of some diseases including some poisoning conditions. However, they were not previously investigated in antipsychotic poisoning. Aim The current study aimed to construct a nomogram to predict the need for ICU admission in acute antipsychotic poisoning. Patients and methods: This 2-year study included 140 patients acutely intoxicated with antipsychotics and admitted at Tanta University Poison Control Centre throughout July 2019 to June 2021. Personal and toxicological data, findings of clinical examination and electrocardiography, as well as, results of laboratory investigations at time of admission were recorded. According to the outcome, patients were divided into ICU-admitted and ICU-not admitted groups. Results The results of this study provided a proposed nomogram that included five significant independent predictors for ICU admission in acute antipsychotic intoxications; the presence of seizures (OR: 31132.26[108.97-Inf]), corrected QT interval (OR: 1.04[1.01–1.09]), mean arterial blood pressure (OR: 0.83[0.70–0.92]), oxygen saturation (OR: 0.62[0.40 to 0.83)], and Glasgow Coma Scale (OR: 0.25 [0.06–0.56]). Conclusion It could be concluded that the developed nomogram is a promising tool for easy and rapid decision making to predict the need for ICU admission in acute antipsychotic poisoning.

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A Prospective Study of Poisoning Severity Score among Acute Antipsychotic Poisoned Cases Admitted to Menoufia Poison Control Center (MPCC) Throughout One Year

Cited by 2 publications

References 29 publications

Risk Factors for the Need of Intensive Care Unit Admission Among Acute Clozapine Poisoned Patients: A Retrospective Cohort Study

Risk Factors for the Need of Intensive Care Unit Admission Among Acute Clozapine Poisoned Patients: A Retrospective Cohort Study

A nomogram proposal for early prediction of intensive care unit admission in patients with acute antipsychotic poisoning

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