TY  - JOUR
PY  - 2020//
TI  - A predictive model for serious adverse events in adults with acute poisoning in prehospital and hospital care
JO  - Australian critical care
A1  - Martín-Rodríguez, Francisco
A1  - López-Izquierdo, Raúl
A1  - Castro-Villamor, Miguel A.
A1  - Martín-Conty, José L.
A1  - Herrero-Antón, Rosa M.
A1  - Del Pozo-Vegas, Carlos
A1  - Guillén-Gil, David
A1  - Dueñas-Laita, Antonio
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: The objective of this study was to design a risk model with variables determined before hospital arrival to predict the risk of serious adverse events in patients with acute poisoning.     METHODS: A preliminary prospective, multicentre cohort study of adults with prehospital diagnosis of acute intoxication was conducted. The study was carried out in the Public Health System of the Community of Castilla-Leon (Spain), including seven advanced life support units and five hospitals, between April 1, 2018, and June 30, 2019. People aged >18 years with a main prehospital diagnosis of acute poisoning admitted to a referral hospital on advanced life support were included. The main outcome measure was prehospital and hospital serious adverse events in patients with acute poisoning.     RESULTS: We included 221 patients, with a median age of 47 years (interquartile range: 33-61). The most frequent cause of poisoning was psychopharmaceuticals (111 cases, 49.8%): 38 (17.2%) patients had a serious adverse event, with a hospital mortality of 4.1% (nine cases) in the 30 days after the index event. The final model included age ≥65 years (odds ratio [OR]: 9.59, 95% confidence interval [CI]: 3.48-26.45; p < 0.001), oxygen saturation/fraction of inspired oxygen index ≤300 (OR: 15.03, 95% CI: 5.74-39.33; p < 0.001), and point-of-care lactate ≥4 mmol/L (OR: 7.68, 95% CI: 2.88-20.45; p < 0.001). The poisoning Early Warning Score was constructed from these three variables, and 1 point was assigned to each variable. The area under the curve of the score was 0.896 (95% CI: 0.82-0.96; p < 0.001).     CONCLUSIONS: The poisoning Early Warning Score may help in decision-making and promote early identification of high-risk patients with acute poisoning in the prehospital context.<p />  <p>Language: en</p>
LA  - en
SN  - 1036-7314
UR  - http://dx.doi.org/10.1016/j.aucc.2020.07.004
ID  - ref1
ER  -