Evaluating the Use of Apache II Score in Predicting the Severity and Clinical Outcomes of Organophosphorous Poisoning-Original Study

Abstract

Objectives: To identify predictors of mortality in OPC poisoned patients and also to evaluate the performanceof APACHE II scoring systemfso r predicting severity and the outcome of patients poisoned with OPC who wereadmitted to the ICU.Methods: A single centre observational study conducted in ICU of a tertiary care teaching hospital inchennai,INDIA. Patients are subjected to history questioning, clinical examinations and blood samplingfor complete blood count,renal function test,serum sodium and potassium,arterial blood gas and also vitalparameters including rectal temperature, oxygen saturation, respiratory rate, pulse rate and blood pressurewere recorded.The APACHE score is calculated from the worst values obtained during the first 24 hours of ICUadmission. The 24 hour time window is necessary to allow us to measure all the needed variables to calculate theAPACHE 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. Thedifference 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 ourstudy are age, Glasgow coma scale, rectal temperature, respiratory rate, pH, oxygenation, serum urea, serumcreatinine and serum potassium.Conclusion: APACHE II score predicts the severity of acute physiological dysfunction due to multi organinvolvement in OPC poisoning and can be recommended as a useful scoring system in OPC poisonings in ICUsettings.