Comparison of four prognostic markers in opioid poisoned patients admitted in ICU

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KHADEM REZAIYAN MAJID; NAJARI FARES; DADPOUR BITA

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Journal: TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ) Year:2020 | Volume:78 | Issue:8 Page(s): 515-521

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Title

Comparison of four prognostic markers in opioid poisoned patients admitted in ICU

Author(s)

KHADEM REZAIYAN MAJID | NAJARI FARES | DADPOUR BITA | Issue Writer Certificate

Keywords

APACHEQ2

intensive care unitsQ2

poisoningQ3

opioidQ3

simplified acute physiology score IIQ1

Abstract

Background: opioid poisoning is the most common type of poisoning in intensive care units (ICUs). This group usually includes patients who have been drug abusers for a long time and now require hospitalization either because of acute overdose or due to side effects of routine opioid use. This study aimed to compare the severity and prognosis of patients using common mortality predictors Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score (SAPS II), Acute Physiology And Chronic Health Evaluation (APACHE II, APACHE IV) on different days of hospitalization. Methods: This cross-sectional study was performed on all patients with opioid poisoning admitted to the ICU, Imam Reza Hospital, Mashhad, Iran, from the beginning of April 2016 to March 2017 (Persian Calendar). For all poisoned patients enrolled in the study, the four mortality predicting tools were filled daily in the first three days of hospitalization and then every other day until discharge from the ICU or patient's death. Results: Overall, 57 patients were evaluated of whom 72% (41 patients) were male. The mean age was 49. 9± 19. 8 (median 53, range 18-94) years. The mean length of stay in the ICU was 13. 5± 17. 5 (median 7, range: 75-75) days. The mortality rate was 17. 5% (10 patients). The scores of SOFA, SAPS II, APACHE II, and APACHE IV were significantly higher in deceased patients than in discharged ones. The highest diagnostic accuracy (area under the curve) for all four predicting tools was observed in the second week of hospitalization. On the other hand, SAPS II (74%) on the first day, APACHEII (76%) on the second day, APACHE-II (82%) on the third day, SOFA (77%) on day 4-5, and SAPS II (82%) on day 6-7 had the highest diagnostic accuracy. Conclusion: In the present study scores of all four mortality predicting tools at admission were significantly associated with mortality. The accuracy of SAPS II, APACHE IV, and APACHE II are appropriate for estimating prognosis, especially after the second week of admission.

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APA: Copy

KHADEM REZAIYAN, MAJID, NAJARI, FARES, & DADPOUR, BITA. (2020). Comparison of four prognostic markers in opioid poisoned patients admitted in ICU. TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ), 78(8 ), 515-521. SID. https://sid.ir/paper/379800/en

Vancouver: Copy

KHADEM REZAIYAN MAJID, NAJARI FARES, DADPOUR BITA. Comparison of four prognostic markers in opioid poisoned patients admitted in ICU. TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)[Internet]. 2020;78(8 ):515-521. Available from: https://sid.ir/paper/379800/en

IEEE: Copy

MAJID KHADEM REZAIYAN, FARES NAJARI, and BITA DADPOUR, “Comparison of four prognostic markers in opioid poisoned patients admitted in ICU,” TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ), vol. 78, no. 8 , pp. 515–521, 2020, [Online]. Available: https://sid.ir/paper/379800/en

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