Effectiveness of Different Scoring Systems in Predicting Severity and Outcome of Acute Poisoning in Adults: A Prospective Study in Sohag University Hospitals, Egypt.

Document Type : Original Article

Authors

1 Forensic Medicine and Clinical Toxicology department, Faculty of Medicine , sohag university, sohag, Egypt.

2 Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Sohag University, Sohag, Egypt

Abstract

Introduction: Prompt and precise evaluation of acutely poisoned patients attending the Emergency Department (ED) is crucial as it can help in the early identification of patients who may require Intensive Care Unit (ICU) admission or are at risk of mortality. Objectives:  Evaluating the effectiveness of five scoring systems (Rapid Emergency Medicine Score (REMS), Modified early warning score (MEWS), Rapid acute physiology score (RAPS), Worthing physiological score (WPS), and National early warning score2 (NEWS2) in predicting severity and outcome of acute adult poisoning. Methods: A prospective study was conducted on 159 acutely poisoned adult patients who were presented to ED at Sohag University hospitals from December 2023 to November 2024. The receiver operating characteristic curve was utilized for evaluating the discrimination power of the scoring systems. Results: On-admission evaluation of all patients by using the five scoring systems revealed that all scores were significantly higher in ICU-needed patients, mechanically ventilated, and non-survivors. NEWS2 had the best accuracy for predicting ICU admission and mortality (97.4% and 97.1% respectively). REMS showed the best accuracy for Mechanical Ventilation (MV) requirement prediction. Conclusion: NEWS2, REMS, RAPS, WPS, and MEWS are simple, rapid, and effective tools to predict the patient’s
need for ICU admission, MV, and death in acutely poisoned adult patients.

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