The Intensive Care Unit Admission Criteria For Patients With Poisoning

Year 2019, Volume: 1 Issue: 2, 59 - 64, 03.09.2019

Dilber Üçöz Kocaşaban , Volkan Arslan Yahya Kemal Günaydın Mehmet Okumuş

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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