The Intensive Care Unit Admission Criteria For Patients With Poisoning
Objective: Poisoning is an important health problem in Turkey and all over the world. We believe that the creation of ideal scoring systems for patients with poisoning is essential for the determination of intensive care hospitalization necessity, duration of follow-up, mortality and morbidity.
Methods: In our study, we included over-18-year-old 292 patients with poisoning who were urgently hospitalized into the intensive care unit between January 2016 to December 2017. We have identified some criteria which are named as Ankara Poisoning Criterion. Glasgow Coma Score (GCS) (<15); hypotension (systolic blood pressure< 90 mm Hg); bradycardia (<60 beats/min) or tachycardia (> 100 beats/min); lactate level (2.0); and the pH value (< 7.35 or >7.45). OR The main decisive factor in the selection of these five criteria (Glaskow coma score <15, systolic blood pressure <90 mm Hg, bradycardia (<60 beats / min) or tachycardia (> 100 beats / min), acidosis (pH < 7,359 or alkalosis (pH> 7,45) and serum lactate level> 2.0 mmol / L), We anticipated that a patient who meets at least one of these criteria is in need of intensive care hospitalization, and that if s/he does not, there is no need for intensive care hospitalization. The patient’s scores of Acute Physiology and Chronic Health Evaluation II (ApacheII), Sequential Organ Failure Assessment Score (SOFA), Quick Sequential Organ Failure Assessment (QSOFA), Modified Early Warning Score (MEWS), and Systemic Inflammatory Response Syndrome (SIRS), and length of hospital stay (LOS), inotrop, dialysis, mechanical ventilation, special treatment, and antidote needs were recorded and these parameters were compared with the Ankara Poisoning Criteria.
Results: Of the 292 patients included in the Ankara Poisoning Criteria, 45.5% (n = 133) had zero scores; therefore they did not need to remain in intensive care. We statistically revealed that patients with the LOS ≥2, and need of inotrop, dialysis, mechanical ventilation, special treatment, and antidote, meet at least one of the Ankara Toxicity Criteria (p <0.005). Meanwhile, we statistically observed correlations between the Apache II, SOFA, QSOFA, MEWS, and SIRS scores and revealed criteria (p <0.005).
Conclusion: We concluded that the Ankara Poisoning Criteria, which consists of 5 criteria that can be easily and quickly obtained in the emergency services, can prevent unnecessary intensive care hospitalizations and they will be beneficial for the prognosis and mortality-morbidity of patients.
Eurasian J Critical Care. 2019;1(2):59-64 EJCC