Comparison of four prognostic markers in opioid poisoned patients admitted in ICU
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...
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| Format: | Article |
| Language: | fas |
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Tehran University of Medical Sciences
2020-10-01
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| Series: | Tehran University Medical Journal |
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| Online Access: | http://tumj.tums.ac.ir/article-1-10785-en.html |
| _version_ | 1811332971614961664 |
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| author | Majid Khadem-Rezaiyan Fares Najari Bita Dadpour |
| author_facet | Majid Khadem-Rezaiyan Fares Najari Bita Dadpour |
| author_sort | Majid Khadem-Rezaiyan |
| collection | DOAJ |
| description | 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 patientchr('39')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, APACHE-II (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. |
| first_indexed | 2024-04-13T16:45:01Z |
| format | Article |
| id | doaj.art-dfe36df4bb484c4594caac2fc54d0e2e |
| institution | Directory Open Access Journal |
| issn | 1683-1764 1735-7322 |
| language | fas |
| last_indexed | 2024-04-13T16:45:01Z |
| publishDate | 2020-10-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Tehran University Medical Journal |
| spelling | doaj.art-dfe36df4bb484c4594caac2fc54d0e2e2022-12-22T02:39:06ZfasTehran University of Medical SciencesTehran University Medical Journal1683-17641735-73222020-10-01788515521Comparison of four prognostic markers in opioid poisoned patients admitted in ICUMajid Khadem-Rezaiyan0Fares Najari1Bita Dadpour2 Clinical Research Development, Akbar Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Department of Forensic Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad. Iran. 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 patientchr('39')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, APACHE-II (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.http://tumj.tums.ac.ir/article-1-10785-en.htmlapacheintensive care unitspoisoningopioidsimplified acute physiology score ii. |
| spellingShingle | Majid Khadem-Rezaiyan Fares Najari Bita Dadpour Comparison of four prognostic markers in opioid poisoned patients admitted in ICU Tehran University Medical Journal apache intensive care units poisoning opioid simplified acute physiology score ii. |
| title | Comparison of four prognostic markers in opioid
poisoned patients admitted in ICU |
| title_full | Comparison of four prognostic markers in opioid
poisoned patients admitted in ICU |
| title_fullStr | Comparison of four prognostic markers in opioid
poisoned patients admitted in ICU |
| title_full_unstemmed | Comparison of four prognostic markers in opioid
poisoned patients admitted in ICU |
| title_short | Comparison of four prognostic markers in opioid
poisoned patients admitted in ICU |
| title_sort | comparison of four prognostic markers in opioid poisoned patients admitted in icu |
| topic | apache intensive care units poisoning opioid simplified acute physiology score ii. |
| url | http://tumj.tums.ac.ir/article-1-10785-en.html |
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