The Intensive Care Unit Admission Criteria For Patients With Poisoning

Abstract

Introduction: Poisoning is an important health problem in Turkey and  in 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.

Materials-Method: In our study we included over-18-year-old 292 patients with poisoning who were urgently hospitalized into the intensive care unit between 2016-2017. We determined some criteria and called it as "Ankara Poisoning Criteria" and their characteristics are as follows: 1) GCS must be <15, 2) hypotension (systolic blood pressure must be <90 mm Hg), 3) bradycardia (must be <60 beats/min) or tachycardia (must be > 100 beats/min 4) lactate level must be high (> 2.0), 5) the pH value must be acidotic or alkalotic (<7.35 or >7.45). 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 ApacheII, SOFA, QSOFA, MEWS and SIRS, and length of hospital stay, inotrop, dialysis, mechanical ventilation, special treatment and antidote needs were recorded and these parameters were compared with the Ankara Poisoning Criteria.

Results: When we evaluated 292 patients included in the study within the scope of the Ankara Poisoning Criteria, we detected that 45.5% (n = 133) of patients had a zero point, thereby we concluded that their stay in the intensive care unit was unnecessary. We statistically revealed that patients with the length of hospital stay ≥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 consist 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.

Keywords

• Poisoning,Intensive Care

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