Determining and comparing predictive and intensity value of severity scores – “Sequential organ failure assessment score,” “Acute physiology and chronic health Evaluation 4,” and “Poisoning severity score” – in short-term clinical outcome of patients with poisoning in an ICU

IntroductIonToxicant refers to any substance that can harm living beings including animals and plants.Furthermore, in clinical toxicology, poisoning refers to a state that toxic destroys normal physiological function and kills or damages human beings.[1] Although there are no comprehensive statistics of poisoning rate and its consequences in Iran, five million cases of poisoning and 12,000 deaths occur in America yearly.[2,3] As many of poisoned patients were admitted in the Intensive Care Unit (ICU) due to physiological instability and disruption of their vital systems including heart, kidney, and lung that careful Introduction: Today, poisoning is one of the problems of society and it is always one of the ten leading causes of death among youth.This study aimed to determine and compare the predictive and intensity value of three standard criteria of "Sequential Organ Failure Assessment (SOFA) score," "Acute Physiology and Chronic Health Evaluation (APACHE) 4," and "Poisoning Severity Score (PSS)" in short-term clinical outcome of poisoned patients.Methods: The prospective study conducted on 120 patients of critical care units.Data were collected using a demographic form and three criteria forms.The researcher was visiting the critical care unit daily and was filling out the demographic form of each patient in the first 24 h of hospital admission.The data were analyzed using SPSS version 16.Results: The results showed the mean age of patients was 35.73 ± 18.46 years with the most frequency among male patients (66.7%).The mean of criteria scores of "SOFA score," "APACHE 4," and "PSS" was 7.3 ± 2.97, P = 0.009; 62.43 ± 12.48, P = 0.58; and 2.4 ± 0.5, P = 0.001, respectively.The accuracy, sensitivity, specificity, positive and negative predictive values, and area under the curve of "SOFA score," "APACHE 4," and "PSS" were 86.2, 70.6, 94.4, 98.6, 36.2, 0.897; 83.5, 90.2, 44.4,90.2, 44.4,0.808; and 16.7, 100, 2, 100, 15.3, 0.786, respectively.Predicted mortality rate in "SOFA score" and "APACHE 4" was 18.7% ±20.2% and 2.63% ±2.6%, respectively.Real mortality rate, predictive duration of hospitalization by APACHE 4 criteria, and real duration of hospitalization were 15%, 1.79 ± 1.35, and 4.04 ± 4.08, respectively.Conclusion: The study showed that "SOFA score" was more predictive in clinical outcomes due to poisoning and it is recommended to poisoning centers as effective criteria.