Determining and comparing predictive and intensity value of severity scores – “Sequential organ failure assessment score,” “Acute physiology and chronic health Evaluation 4,” and “Poisoning severity score” – in short-term clinical outcome of patients with poisoning in an ICU
Koroush Ebrahimi, Ali Akbar Raigani, Rostam Jalali, Mansour Rezaei
Acute Physiology and Chronic Health Evaluation 4, clinical outcome, Poisoning Severity Score, poisoning, predictive value, Sequential Organ Failure Assessment score
Citation Information :
Ebrahimi K, Raigani AA, Jalali R, Rezaei M. Determining and comparing predictive and intensity value of severity scores – “Sequential organ failure assessment score,” “Acute physiology and chronic health Evaluation 4,” and “Poisoning severity score” – in short-term clinical outcome of patients with poisoning in an ICU. Indian J Crit Care Med 2018; 22 (6):415-421.
Introduction: Today, poisoning is one of the problems of society and it is always one of the ten leading causes of death among youth. This study aimed to determine and compare the predictive and intensity value of three standard criteria of “Sequential Organ Failure Assessment (SOFA) score,” “Acute Physiology and Chronic Health Evaluation (APACHE) 4,” and “Poisoning Severity Score (PSS)” in short-term clinical outcome of poisoned patients. Methods: The prospective study conducted on 120 patients of critical care units. Data were collected using a demographic form and three criteria forms. The researcher was visiting the critical care unit daily and was filling out the demographic form of each patient in the first 24 h of hospital admission. The data were analyzed using SPSS version 16. Results: The results showed the mean age of patients was 35.73 ± 18.46 years with the most frequency among male patients (66.7%). The mean of criteria scores of “SOFA score,” “APACHE 4,” and “PSS” was 7.3 ± 2.97, P = 0.009; 62.43 ± 12.48, P = 0.58; and 2.4 ± 0.5, P = 0.001, respectively. The accuracy, sensitivity, specificity, positive and negative predictive values, and area under the curve of “SOFA score,” “APACHE 4,” and “PSS” were 86.2, 70.6, 94.4, 98.6, 36.2, 0.897; 83.5, 90.2, 44.4, 90.2, 44.4, 0.808; and 16.7, 100, 2, 100, 15.3, 0.786, respectively. Predicted mortality rate in “SOFA score” and “APACHE 4” was 18.7% ±20.2% and 2.63% ±2.6%, respectively. Real mortality rate, predictive duration of hospitalization by APACHE 4 criteria, and real duration of hospitalization were 15%, 1.79 ± 1.35, and 4.04 ± 4.08, respectively. Conclusion: The study showed that “SOFA score” was more predictive in clinical outcomes due to poisoning and it is recommended to poisoning centers as effective criteria.
Shannon MW, Borron SW, Burns M. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: W.B. Saunders; 2007.
Yazdani MR, Tavahen N, Masoumi GR, Gheshlaghi F, Dana-Siadat Z, Setareh M, et al. Demographic factors, duration and costs of hospitalization, and causes of death in patients intoxicated with opioids and amphetamines. Int J Med Toxicol Forensic Med 2014;4:122-9.
Hoffman RS, Howland MA, Lewin NA, Nelson LS, Goldfrank LR (eds). Goldfrank's Toxicologic Emergencies. 10th ed. New York, NY: McGraw-Hill; 2015.
Sam KG, Kondabolu K, Pati D, Kamath A, Pradeep Kumar G, Rao PG, et al. Poisoning severity score, APACHE II and GCS: Effective clinical indices for estimating severity and predicting outcome of acute organophosphorus and carbamate poisoning. J Forensic Leg Med 2009;16:239-47.
Rahimzadeh P, Taghipur Anvari Z, Hassani V. Estimation of mortality rate of patients in surgical Intensive Care Unit of Hazrat-Rasul hospital. Hakim Res J 2008;11:22-8.
Asadzandi M, Taghizade K, Tadrisi S, Ebadi A. Estimation of the mortality rate using the APACHE II standard disease severity scoring system in Intensive Care Unit patients. Iran J Crit Care Nurs 2012;4:209-14.
Reddy NB, Phegde S, Athale N, Ghanekar J. Acute physiological and chronic health examination scoring system in prediction of mortality in critically Ill patients and it's comparison with other scoring systems. Int J Recent Trends Sci Technol 2014;10:7-9.
Sulaj Z, Prifti E, Demiraj A, Strakosha A. Early clinical outcome of acute poisoning cases treated in Intensive Care Unit. Med Arch 2015;69:400-4.
Balci C, Sungurtekin H, Gürses E, Sungurtekin U. APACHE II, APACHE III, SOFA scoring systems, platelet counts and mortality in septic and nonseptic patients. Ulus Travma Acil Cerrahi Derg 2005;11:29-34.
Challa SN, Mohan A, Harikrishna J, Sarma K, Kumar BS. Performance of APACHE II and SOFA scoring systems in patients with sepsis and related syndromes admitted to medical Intensive Care Unit (MICU). J Assoc Physicians India 2016;64:71.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: A severity of disease classification system. Crit Care Med. 1985;13:818-29.
Baheti A. Comparison of APACHE II & SAPS II score in critically ill obstetrics patients admitted in medicine wards & ICU. J Assoc Physicians India 2016;64:44.
Pan K, Panwar A, Roy U, Das BK. A comparison of the intracerebral hemorrhage score and the acute physiology and chronic health evaluation II score for 30-day mortality prediction in spontaneous intracerebral hemorrhage. J Stroke Cerebrovasc Dis 2017;26:2563-9.
Pan HC, Jenq CC, Tsai MH, Fan PC, Chang CH, Chang MY, et al. Scoring systems for 6-month mortality in critically ill cirrhotic patients: A prospective analysis of chronic liver failure-sequential organ failure assessment score (CLIF-SOFA). Aliment Pharmacol Ther 2014;40:1056-65.
Pietraszek-Grzywaczewska I, Bernas S, Łojko P, Piechota A, Piechota M. Predictive value of the APACHE II, SAPS II, SOFA and GCS scoring systems in patients with severe purulent bacterial meningitis. Anaesthesiol Intensive Ther 2016;48:175-9.
Sun D, Ding H, Zhao C, Li Y, Wang J, Yan J, et al. Value of SOFA, APACHE IV and SAPS II scoring systems in predicting short-term mortality in patients with acute myocarditis. Oncotarget 2017;8:63073-83.
Cholongitas E, Theocharidou E, Vasianopoulou P, Betrosian A, Shaw S, Patch D, et al. Comparison of the sequential organ failure assessment score with the King's college hospital criteria and the model for end-stage liver disease score for the prognosis of acetaminophen-induced acute liver failure. Liver Transpl 2012;18:405-12.
Raith EP, Udy AA, Bailey M, McGloughlin S, MacIsaac C, Bellomo R, et al. Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the Intensive Care Unit. JAMA 2017;317:290-300.
Tsaousi GG, Pitsis AA, Ioannidis GD, Pourzitaki CK, Yannacou-Peftoulidou MN, Vasilakos DG. Implementation of EuroSCORE II as an adjunct to APACHE II model and SOFA score, for refining the prognostic accuracy in cardiac surgical patients. J Cardiovasc Surg (Torino) 2015;56:919-27.
Vincent JL, Sakr Y. SOFA so good for predicting long-term outcomes. Resuscitation 2012;83:537-8.
Taghaddosinejad F, Sheikhazadi A, Yaghmaei A, Mehrpour O, Schwake L. Epidemiology and Treatment of Severe Poisoning in the Intensive Care Unit: Lessons from a One-Year Prospective Observational Study. J Clinic Toxicol 2012 S1:007. doi:10.4172/2161-0495.S1-007.
Abd El-Salam HF, Fayed AM, Abdel Muneum MM. Prediction of the Outcome of Patients with Acute Hydrocarbons Poisoning using Poison Severity Scoring System; A Prospective Study. J Am Sci 2011;7:509-518.
Halim DA, Murni TW, Redjeki IS. Comparison of Apache II, SOFA, and modified SOFA scores in predicting mortality of surgical patients in Intensive Care Unit at Dr. Hasan Sadikin General Hospital. Crit Care Shock 2009;12:12.
Moini L, Fani A, Peyroshabani B, Baghinia M. Evaluation of the standards of health care services and comparison of predicted mortality and real mortality in patients admitted to Valiasr and Amiralmomenin Hospitals of Arak by APACHE IV Scoring System (2009-2010). Arak Med Univ J 2011;14:79-85.
Zimmerman JE, Kramer AA, McNair DS, Malila FM. Acute physiology and chronic health evaluation (APACHE) IV: Hospital mortality assessment for today's critically ill patients. Crit Care Med 2006;34:1297-310.
Churi S, Ramesh M, Bhakta K, Chris J. Prospective assessment of patterns, severity and clinical outcome of Indian poisoning incidents. Chem Pharm Bull (Tokyo) 2012;60:859-64.
Davies JO, Eddleston M, Buckley NA. Predicting outcome in acute organophosphorus poisoning with a poison severity score or the Glasgow coma scale. QJM 2008;101:371-9.
Mbongo CL, Monedero P, Guillen-Grima F, Yepes MJ, Vives M, Echarri G, et al. Performance of SAPS3, compared with APACHE II and SOFA, to predict hospital mortality in a general ICU in Southern Europe. Eur J Anaesthesiol 2009;26:940-5.
Peter JV, Thomas L, Graham PL, Moran JL, Abhilash KP, Jasmine S, et al. Performance of clinical scoring systems in acute organophosphate poisoning. Clin Toxicol (Phila) 2013;51:850-4.
Shrestha GS, Gurung R, Amatya R. Comparison of acute physiology, age, chronic health evaluation III score with initial sequential organ failure assessment score to predict ICU mortality. Nepal Med Coll J 2011;13:50-4.