Evaluating the Use of Apache II Score in Predicting the Severity and Clinical Outcomes of Organophosphorous Poisoning-Original Study
DOI:
https://doi.org/10.37506/ijfmt.v17i2.19198Keywords:
APACHE scoring;ICU; Organophosphorus (OPC)Abstract
Objectives: To identify predictors of mortality in OPC poisoned patients and also to evaluate the performance
of APACHE II scoring systemfso r predicting severity and the outcome of patients poisoned with OPC who were
admitted to the ICU.
Methods: A single centre observational study conducted in ICU of a tertiary care teaching hospital in
chennai,INDIA. Patients are subjected to history questioning, clinical examinations and blood sampling
for complete blood count,renal function test,serum sodium and potassium,arterial blood gas and also vital
parameters including rectal temperature, oxygen saturation, respiratory rate, pulse rate and blood pressure
were recorded.The APACHE score is calculated from the worst values obtained during the first 24 hours of ICU
admission. The 24 hour time window is necessary to allow us to measure all the needed variables to calculate the
APACHE score.Each variable is given the weightage of 0-4. The total score obtained will be in the range of 0-71.
Results: 75 patients with confirmed history or documented OPC poisoning were enrolled for study. The
difference in APACHE II score is statistically significant among the survivors(5.70 ± 3.01) and non survivors(19.57
± 3.93) with p value(<0.0001). Other parameters which are shown to be statistically significant [p<0.05] in our
study are age, Glasgow coma scale, rectal temperature, respiratory rate, pH, oxygenation, serum urea, serum
creatinine and serum potassium.
Conclusion: APACHE II score predicts the severity of acute physiological dysfunction due to multi organ
involvement in OPC poisoning and can be recommended as a useful scoring system in OPC poisonings in ICU
settings.
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