Poisoning Severity Score And Its Correlation With APACHE II And Glasgow Coma Scale In Predicting Outcome In Patients Presented With Poisoning In Emergency Department

ABSTRACT

Background:Standardized scales for scoring severity of poisoning is need of time in Emergency department(ED)to identify high risk patients for intensive monitoring and treatment before disposal and for compatibility of data. So in this study we try to evaluate utility of Glasgow coma scale (GCS), poisoning severity score (PSS) and Acute physiology and chronic health evaluation II (APACHE II) in estimating clinical severity and prognosis of poisoning patients.Material and methods: A Retrospective observational study was conducted between1stJune 2019 to 28thFebruary 2021 in the Emergency Department of tertiary care teaching hospital, Ahmedabad, India. Data was collected from computerized hospital information system and analysed in CDC software Epi Info (version 7.3.2.1).Results:Out of total 50 patients during study,majority of patients were in age group of 21-30 year (yr)with Male Female ratio of 11. Out of 50 cases, 44 consumed chemical substances, 3 had corrosive and 3 had medication consumption with organophosphates (OP) being most common compound. Mean PSS in expired was significantly high in comparisonof survivors (p value= 0.0118). Present study found significant association between PSS within first 24 hours and GCS of patients pre sented with poisoning with p value 0.0117 (GCS on admission) and 0.0002 (GCS at 24 hr). A statistically significant correlation was found between PSS and APACHE II, with a p value= 0.0242 and also between GCS and APACHE II with a p value= 0.0018 (CI=95%).Conclusion:Both PSS and GCSare effective in predicting Severity and outcome of patients presented with poisoning in ED.GCSis more useful as it is easy to use, does not require any laboratory investigations and less time consuming.