Comparison of Four Predictive Scoring Systems in poisoned patients admitted in ICU

Introduction: The aim of this study is performance evaluation of four popular predictive scoring systems (APACHE II, APACHE IV, SAPS II, and SOFA) for their prediction of mortality in poisoning patients who are admitted to an intensive care unit (ICU).Methods: This retrospective cross-sectional study was done on all admitted patients in poisoning ICU of Imam Reza Hospital, Mashhad, Iran in a Persian calendar year starting from March 20, 2016. All patients were evaluated for three consecutive days from admission time and then every two days until ICU discharge or death. The aforementioned scoring systems were calculated. Data were analyzed by MedCalc Statistical Software version 18.9.1 and SPSS version 16.Result: Overall, 150 patients were studied out of which 67% (101) were male. Mean±SD of age was 41.6±18.9 years. APACHE II (79.5%), SAPS II (78.7%), APACHE IV (78.4%), and SOFA (72.9%) were the most accurate measures based on the area under the ROC curve, respectively, during the whole hospitalization period. In the first day of admission APACHE II (77.4%), in the second day APACHE II (83.1%), in the third day APACHE II (90.7%) and in the fifth-day SOFA (81.6%) were the most precise measures.Conclusion: All four scoring systems have acceptable discriminatory power for poisoned patients. However, it seems that overall APACHE II score can be used for mortality prediction especially in the early days of admission.