Glasgow Coma Scale and Its Components on Admission: Are They Valuable Prognostic Tools in Acute Mixed Drug Poisoning?

Mood, Nastaran Eizadi; Sabzghabaee, Ali Mohammad; Yadegarfar, Gh.; Yaraghi, Ahmad; Chaleshtori, M. Ramazani

doi:10.1155/2011/952956

Cited by 18 publications

(10 citation statements)

References 29 publications

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“…Poisoning with drugs influences the biochemical substances of the brain and causes brain damage. This may change the level of consciousness as well (Mood et al, 2011).In the current study there was statistically significant difference between discharged and died patients as regard GCS. There were 85% of died had GCS less than or equal to 8.…”

Section: Discussionmentioning

confidence: 43%

Predictive Value of Triage Vital Signs and Conscious Level for Outcome Evaluation in Acutely Organophosphate Poisoned Patients

Moussa

Mohamed

Hilal

et al. 2018

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Triage in Emergency departments requires emergency doctors to make rapid decisions based on their knowledge and experiences. Triage of patients is critical to patient safety, yet no clear information exists by the utility of initial vital signs and conscious level in identifying critically ill acutely organophosphate (OP) poisoned patients. The objective of this study is to determine the relationship between triage vital signs and conscious level in predicting outcome of acutely organophosphate poisoned patients. A retrospective and prospective study was carried out on 200 patients of acute OP poisoning admitted to the Poison Control Center (PCC), Ain Shams University Hospitals. Information including vital signs and Glasgow coma scale (GCS) on admission after obtaining the permission of the director of PCC and the regional ethics committee was collected from the sheets and computerized data base of the patients, an informed written consent has been obtained from each patient or from his/her caregiver for inclusion in the prospective part of the study. The results were revised, coded and organized for statistical analysis. The study results revealed 180 (90%) patients discharged and 20 (10%) patients died. The study also showed that 8% of patients had fever, 9.5% had tachycardia, 1.5% had bradycardia, 5% had hypotension, 2% had hypertension, 2.5% had tachypnea and 3.5% showed bradypnea. Also 89% of patients had GCS > 8, while 11% of patients had GCS ≤ 8. The study showed statistically significant difference between discharged and died patients as regards heart rate, blood pressure, respiratory rate, body temperature and GCS. It could be concluded that heart rate, respiratory rate and coma scale can serve as easily measurable tools for outcome prediction in acutely OP poisoned patients. From the previous results, our study recommends to use these parameters to help emergency physicians to quickly detect poisoned patients with poor outcomes.

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Section: Discussionmentioning

confidence: 43%

Predictive Value of Triage Vital Signs and Conscious Level for Outcome Evaluation in Acutely Organophosphate Poisoned Patients

Moussa

Mohamed

Hilal

et al. 2018

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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“…Although rapid changes in the level of consciousness in poisoning cases may raise a question of the role of GCS on admission in predicting outcome, Ezadi Mood and colleagues 22 showed that the admission GCS score as well as its components can be validated for poisoned patients with mixed drug ingestion.…”

Section: Resultsmentioning

confidence: 99%

Study of Glasgow Coma Scale Score and QTc Interval in Prognosis of Organophosphate Compound Poisoning

Deshpande

Gaikwad

Deshpande³

2012

Indian Journal of Clinical Medicine

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Abstract:We assessed the applicability of the Glasgow Coma Scale (GCS) and the QT interval (QTc) to predicting outcomes in patients with organophosphate (OP) poisoning. In the hospital setting, QTc and GCS were monitored in each patient at admission. Patients with respiratory failure were compared to patients without these complications, and mortality was compared between groups. We found that the group with complications had a significantly longer QTc and a lower GCS score, a higher number of intubations, and worse outcomes (P , 0.05). GCS score and QTc have been shown to be equally good in predicting respiratory failure and hospital mortality in patients with OP poisoning. These results suggest that during initial out-of-hospital care of patients with OP poisoning, it is essential to monitor the QTc and the GCS score. The simplicity and promptness of these methods will allow providers to perform early and effective triage.

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“…This is surely the consequence of the high prevalence of benzodiazepines and other sedative drugs in our study. Nevertheless, the use of GCS remains controversial in acute poisoning because it is not strictly correlated with the risk of gastric aspiration, and there is no consensus on a threshold value that would mandate intubation .…”

Section: Discussionmentioning

confidence: 99%

Deliberate Drug Poisoning with Slight Symptoms on Admission: Are there Predictive Factors for Intensive Care Unit Referral? A three‐year Retrospective Study

Maignan

Pommier

Clot

et al. 2013

Basic Clin Pharma Tox

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Deliberate drug poisoning leads to 1% of emergency department (ED) admissions. Even if most patients do not exhibit any significant complication, 5% need to be referred to an intensive care unit (ICU). Emergency physicians should distinguish between low-and high-acuity poisoned patients at an early stage to avoid excess morbidity. Our aim was to identify ICU transfer factors in deliberately self-poisoned patients without life-threatening symptoms on admission. We performed a 3-year retrospective observational study in a university hospital. Patients over 18 years of age with a diagnosis of deliberate drug poisoning were included. Clinical and toxicological data were analysed with univariate tests between groups (ED stay versus ICU transfer). Factors associated with ICU admission were then included in a logistic regression analysis. Two thousand five hundred and sixtyfive patients were included. 63.2% were women, and median age was 40 (28-49). 142 patients (5.5%) were transferred to ICU. Cardiac drugs [adjusted OR (aOR) = 19.81; 95% confidence interval (95% CI): 7.93-49.50], neuroleptics (aOR = 2.78; 95% CI: 1.55-4.97) and meprobamate (aOR = 2.71; 95% CI: 1.27-5.81) ingestions were significantly linked to ICU admission. A presumed toxic dose ingestion (aOR = 2.27; 95% CI: 1.28-4.02), number of ingested tablets (aOR = 1.01; 95% CI: 1.01-1.02 for each tablet) and delay between ingestion and ED arrival <2 hr (aOR = 2.85; 95%CI: 1.62-5.03) were also factors for ICU referral. The Glasgow Coma Scale was the only clinical feature associated with ICU admission (aOR = 1.57; 95% CI: 1.44-1.70 for each point loss). These results suggest that emergency physicians should pay particular attention to toxicological data on ED admission to distinguish between low-and high-acuity self-poisoned patients.Deliberate drug poisoning (DDP) is a major public health problem with more than 210,000 patients hospitalized in the United States in 2010 [1]. The annual incidence of DDP is around 2-6& in most western countries and DDP accounts for 1% of all emergency department (ED) visits [1][2][3][4]. One major problem concerning the ED management of such a high number of DDP patients is the respective proportion of lowand high-acuity patients. On the one hand, the vast majority of DDP patients attending the ED do not have any severe symptoms and do not require any specific intervention [5,6]. Inappropriate recognition of such patients lead to unnecessary laboratory testing and/or ward monitoring, and it finally contributes to overcrowding [7,8]. On the other hand, around 5% of DDP patients exhibit complications, with an increased mortality rate up to 10-20% [9,10]. Appropriate identification of severe DDP is therefore crucial to avoid delayed intensive treatments and increased in-hospital mortality [11][12][13][14].Emergency physicians cannot rely on strong and validated indicators for the assessment of DDP patients. Although severity factors for specific intoxications are usually well-known, few data exist about patients overdosed w...

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Glasgow Coma Scale and Its Components on Admission: Are They Valuable Prognostic Tools in Acute Mixed Drug Poisoning?

Cited by 18 publications

References 29 publications

Predictive Value of Triage Vital Signs and Conscious Level for Outcome Evaluation in Acutely Organophosphate Poisoned Patients

Predictive Value of Triage Vital Signs and Conscious Level for Outcome Evaluation in Acutely Organophosphate Poisoned Patients

Study of Glasgow Coma Scale Score and QTc Interval in Prognosis of Organophosphate Compound Poisoning

Deliberate Drug Poisoning with Slight Symptoms on Admission: Are there Predictive Factors for Intensive Care Unit Referral? A three‐year Retrospective Study

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