Clinical Use of The Poisoning Severity Score in Acute Pediatric Poisoning

Abstract

Background: To make an accurate diagnosis of poisoning and determine the severity of poisoning quickly without losing time are critical for managing the patient's medical treatment and predicting the prognosis. This study aimed to investigate PSS and Glasgow Coma Scale Score (GCS) effectiveness in predicting outcomes in acute pediatric poisoning. Methods: We retrospectively reviewed the data of intoxicated patients aged under 18 years who were admitted to the pediatric emergency service of Ondokuz Mayıs University Faculty of Medicine Clinical Research and Practice Hospital between January 1, 2018 and December 31, 2018. Results: Two hundred twenty-two patients were admitted to our pediatric emergency department (ED) after drug ingestions. Of the patients enrolled in the study, 148 (66.7 %) were female, and 74 (33.3%) were male. The mean age was 105.8±75.3 months, and the median age was 65 (12-213) months. 96 (43.3%) poisoning cases were in the age range of 12-18 years. According to Poisoning Severity Score, it was found that 84 cases (37.4%) were asymptomatic (PSS score=0), 86 cases (38.7%) were minor (PSS score=1), 48 cases (21.6%) were moderate (score=2) and 4 cases (1.8%) were severe (PSS score=3). Conclusions: Combined using the Poisoning Severity Score with the patient's biochemical and physiological values may help improve an accurate diagnosis of poisoning and determine the severity of poisoning more accurately.

Keywords

• poisoning severity score
• pediatric
• intoxication

References

1. REFERENCES 1. Abahussain EA, Ball DE. Pharmaceutical and chemical pediatric poisoning in Kuwait: a retrospective survey. Pharmacy practice. 2010;8(1):43.
2. 2. Davies JO, Eddleston M, Buckley NA. Predicting outcome in acute organophosphorus poisoning with a poison severity score or the Glasgow coma scale. QJM: An International Journal of Medicine. 2008;101(5):371-9.
3. 3. Adams RD, Gibson AL, Good AM, Bateman DN. Systematic differences between healthcare professionals and poison information staff in the severity scoring of pesticide exposures. Clinical toxicology. 2010;48(6):550-8.
4. 4. Persson HE, Sjöberg GK, Haines JA, de Garbino JP. Poisoning severity score. Grading of acute poisoning. Journal of Toxicology: Clinical Toxicology. 1998;36(3):205-13.
5. 5. Schwarz ES, Kopec KT, Wiegand TJ, Wax PM, Brent J. Should we be using the poisoning severity score? Journal of medical toxicology. 2017;13(2):135-45.
6. 6. Sahin S, Carman KB, Dinleyici EC. Acute poisoning in children; data of a pediatric emergency unit. Iranian journal of pediatrics. 2011;21(4):479.
7. 7. Mintegi S, Fernandez A, Alustiza J, Canduela V, Mongil I, Caubet I, et al. Emergency visits for childhood poisoning: a 2-year prospective multicenter survey in Spain. Pediatr Emerg Care. 2006;22(5):334-8.
8. 8. Chhetri UD, Ansari I, Shrestha S. Pattern of pediatric poisoning and accident in Patan Hospital. Kathmandu Univ Med J (KUMJ). 2012;10(39):39-43.

9. 9. Alagözlü H, Sezer H, Candan F, Tabak E, ELALDI N. A survey of patients with acute poisoning in the Sivas region, Turkey, between 1994 and 1998. Turkish Journal of Medical Sciences. 2002;32(1):39-42.
10. 10. Akdur O, Durukan P, Ozkan S, Avsarogullari L, Vardar A, Kavalci C, et al. Poisoning severity score, Glasgow coma scale, corrected QT interval in acute organophosphate poisoning. Human & experimental toxicology. 2010;29(5):419-25.
11. 11. Nouira S, Abroug F, Elatrous S, Boujdaria R, Bouchoucha S. Prognostic value of serum cholinesterase in organophosphate poisoning. Chest. 1994;106(6):1811-4.
12. 12. Tsao TC-Y, Juang Y-C, Lan R-S, Shieh W-B, Lee C-H. Respiratory failure of acute organophosphate and carbamate poisoning. Chest. 1990;98(3):631-6.
13. 13. Churi S, Bhakta K, Madhan R. Organophosphate poisoning: prediction of severity and outcome by Glasgow Coma Scale, poisoning severity score, Acute Physiology and Chronic Health Evaluation II score, and Simplified Acute Physiology Score II. Journal of emergency nursing. 2012;38(5):493-5.