Poisoning severity score, APACHE II and GCS: Effective clinical indices for estimating severity and predicting outcome of acute organophosphorus and carbamate poisoning

Sam, Kishore Gnana; Kondabolu, Krishnakanth; Pati, Dipanwita; Kamath, Asha; Kumar, G. Pradeep; Rao, Padma Gm

doi:10.1016/j.jflm.2008.12.004

Cited by 97 publications

(120 citation statements)

References 24 publications

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“…Davies et al, reported that the Glasgow coma scale and the International Program on Chemical Safety Poison Severity Score (IPCS PSS) were similarly effective in predicting outcomes from OP poisonings [35]. A prospective descriptive survey to assess the utility of severity scales in 71 patients with organophosphate (OP) and carbamate poisoning over a one year period concluded that significant correlation (p < 0.05) between poisoning severity score and GCS and APACHE II and predicted mortality rate were observed with the poisoning severity score predicting mortality significantly (p < 0.001) [36].…”

Section: Discussionmentioning

confidence: 99%

Acute Poisonings Admitted to a Tertiary Level Intensive Care Unit in Northern India: Patient Profile and Outcomes

Ahuja¹

2015

JCDR

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Section: Discussionmentioning

confidence: 99%

Acute Poisonings Admitted to a Tertiary Level Intensive Care Unit in Northern India: Patient Profile and Outcomes

Ahuja¹

2015

JCDR

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“…10 Another Indian study reported that parameters like GCS, APACHE II, predicted mortality rate (PMR) can be used to predict mortality in OP poisoning. 25 In 2011, it was reported that serum creatinine phosphokinase, R.B.C cholinesterase level, blood pH and total atropine dose required were strongly correlated with clinical severity. 26 We observed that cases requiring ventilatory support had higher mean random sugar level, lower mean saturation of oxygen, GCS less than 13 and lower mean serum pseudo cholinesterase levels.…”

Section: Variablementioning

confidence: 99%

The clinico-demographic study of morbidity and mortality in patients with organophosphate compound poisoning at tertiary care hospital in rural India

Mundhe¹,

Birajdar²,

Chavan³

2017

Int J Adv Med

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Background: Organophosphates (OP) are commonly used and potentially fatal insecticides. Given the unrestricted availability and widespread use, OP poisoning is very much common following either accidental or intentional exposures. Many parameters are proposed to predict outcome, yet there is no consensus about these parameters. This study aimed to investigate different factors associate with morbidity and mortality in rural population that can help in identifying patients in need of intensive care and treatment to prevent deaths.Methods: This was a cross-sectional observational study of 323 patients, admitted to the tertiary care rural public hospital with OP poisoning between December 2015 to November 2016.Results: Of the 323 patients studied, 62.85% were male, 227 (70.27%) were suicides, 241 (74.61%) ingested OP compounds, 40 (12.38%) patients developed intermediate syndrome and 56 (17.34%) died. There were statistically significant differences between ventilatory support group and no ventilatory group for suicidal intention, sex, comorbid psychiatric conditions, route of exposure, certain clinical features on admission, GCS score, POP scale, time from exposure to initiation of treatment, plasma pseudocholinesterase levels, oxygen saturation, and random blood sugar levels (p<0.05).Conclusions: OP poisoning is a life-threatening condition which requires immediate management. Early initiation of decontamination, atropine and pralidoxime therapy, with supportive ICU care, can save lives. Different demographic, exposure related parameters; some of the clinical features, treatment variables and certain laboratory findings can provide useful prognostic information and help to predict outcomes. A measures to control unchecked availability of these compounds and early transfer of victims to health care facility is needed to save many lives.

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“…The analysis of the signs and symptoms, together, corroborated this finding. 24,25 The results of this work also revealed that, if the patient enters the hospital with two of the typical intoxication symptoms, the administration of atropine ampoules (p <0.0001) and the use of activated charcoal (p=0.0009) are indicated and there is no need to wait for the appearance of four or more symptoms. 26 In general, our study also identified a statistically significant relation between the number of symptoms presented by the patient, the length of stay and the use of activated charcoal and atropine ampoules, suggesting that, in the presence of certain signs and symptoms, a longer hospital stay can be expected.…”

Section: Figurementioning

confidence: 69%

“…Anxiety (n=31) appeared to be an uncommon symptom for patients in serious condition of intoxication, being more common in those who were not at risk of death. [22][23][24] The average length of hospital stay in our study was 2.94 ± 5.45 days. It is known that this period varies according to the patient's condition and the severity of the intoxication.…”

Section: Figurementioning

confidence: 99%

Management of exogenous intoxication by carbamates and organophosphates at an emergency unit

Leão

Araújo

Silveira

et al. 2015

Rev. Assoc. Med. Bras.

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Conflict of interest: noneObjectives: to evaluate and indicate the procedure to be followed in the health unit, both for diagnosis and the treatment of acute exogenous intoxications by carbamates or organophosphates. Methods: a descriptive study based on retrospective analysis of the clinical history of patients diagnosed with intoxication by carbamates or organophosphates admitted at the emergency unit of the Hospital de Urgências de Sergipe Governador João Alves (HUSE) between January and December of 2012. Some criteria were evaluated, such as: intoxicating agent; patient's age and gender; place of event, cause, circumstances and severity of the intoxication; as well as signs and symptoms of the muscarinic, nicotinic and neurological effects. Results: seventy patients (average age: 25±19.97) formed the study's population. It was observed that 77.14% of them suffered carbamate intoxication. However, organophosphate intoxications were more severe, with 68.75% of patients presenting moderate to severe forms. Suicide attempt was the leading cause of poisoning, with 62 cases (88.57% of total). Atropine administration was an effective therapeutic approach for treating signs and symptoms, which included sialorrhea (p=0.0006), nausea (p=0. 0029) and emesis (p <0.0001). The use of activated charcoal was shown effective, both in combating the signs and symptoms presented by both patient groups (p <0.0001). Conclusion: it is concluded that the use of atropine and activated charcoal is highly effective to treat the signs and symptoms developed by patients presenting acute exogenous intoxication by carbamates or organophosphates.

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Poisoning severity score, APACHE II and GCS: Effective clinical indices for estimating severity and predicting outcome of acute organophosphorus and carbamate poisoning

Cited by 97 publications

References 24 publications

Acute Poisonings Admitted to a Tertiary Level Intensive Care Unit in Northern India: Patient Profile and Outcomes

Acute Poisonings Admitted to a Tertiary Level Intensive Care Unit in Northern India: Patient Profile and Outcomes

The clinico-demographic study of morbidity and mortality in patients with organophosphate compound poisoning at tertiary care hospital in rural India

Management of exogenous intoxication by carbamates and organophosphates at an emergency unit

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