Independent validation of the Tanta University Risk Model for intensive care requirement in acutely poisoned adults. (3rd April 2023)

• Record Type: Journal Article
• Authors: Schmoll, Sabrina; Heier, Eva-Carina; Böll, Regina; Zellner, Tobias; Romanek, Katrin; Eyer, Florian; Rabe, Christian; Geith, Stefanie
• Is Part Of: Clinical toxicology. Volume 61:Number 4(2023)
• Page Start: 266
• Page End: 269
• Publication Date: 2023-04-03
• Subjects: Intoxication -- score -- prediction -- complication -- intensive care; Toxicology -- Periodicals; Toxicological emergencies -- Periodicals; 615.9
• DOI: 10.1080/15563650.2023.2188142
• Languages: English
• ISSNs: 1556-3650

Abstract

Abstract: Objective: To independently validate the predictive value of the Tanta University Risk Model for intensive care requirement in unselected poisoned patients. Method: Retrospective chart review of 293 poisoned patients. The Tanta University Risk Model was calculated as follows: Tanta University Risk Model = −1.966*Glasgow Coma Scale − 0.329*oxygen saturation − 0.212*diastolic blood pressure + 0.27*respiratory rate − 0.33*standard bicarbonate. It was then compared to a composite endpoint indicating an intensive care unit requirement (death in hospital, vasopressors, need for intubation). Results: Nineteen of 293 patients had a complicated clinical course as defined by meeting the primary endpoint definition. Receiver operating characteristic analysis revealed the area under the curve to be 0.79 (95% confidence interval 0.73–0.83). A positive Tanta University Risk Model was defined >−73.46. Fifteen out of 84 patients with a positive Tanta University Risk Model had a complicated course, while four of 209 patients with a negative Tanta University risk model had a complicated course ( P <0.0001, Fisher's exact test). The negative predictive value of the Tanta University Risk Model was 0.98 (95% confidence interval 0.95–0.99), the sensitivity was 0.79 and that specificity was 0.75. Conclusion: Poisoned patients with a negative Tanta University Risk Model score are unlikely to need an intensive care unit level of care.