15Aug 2017

A PROSPECTIVE OBSERVATIONAL STUDY COMPARING THE ACCURACY OF APACHE IV AND SAPS II SCORING SYSTEMS IN PREDICTING THE OUTCOME OF ORGANOPHOSPHATE POISONING PATIENTS ADMITTED TO AN INTENSIVE CARE UNIT IN KASHMIR VALLEY.

  • Senior Resident, Postgraduate Department of Anaesthesiology, Government Medical College, Srinagar.
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Introduction: Organophosphates are one of the most common causes of poisoning in developing countries, with high morbidity and mortality. As mortality rate of organophosphate poisoning is still high, early diagnosis and appropriate treatment is often lifesaving. Acute poisoning constitutes a significant proportion of Intensive Care Unit (ICU) admissions and even though the overall mortality may be low, they utilise considerable ICU resources. Organophosphates are the main cause of poisoning and death in the Intensive Care Unit of Department of Anaesthesiology and Critical Care, Govt. Medical College Srinagar. Objective: To compare the accuracy of Acute Physiology and Chronic health evaluation IV score (APACHE IV) and Simplified Acute Physiology II score (SAPS II) in the prediction of mortality in patients of organophosphate poisoning admitted to the Intensive Care Unit (ICU) of the Department of Anaesthesiology and Critical Care, Govt. Medical College Srinagar between March 2013 and August 2014. Methods: A prospective study was conducted by collecting data on patients with acute Organophosphate poisoning patients admitted to the Intensive Care unit between March 2013 and August 2014. Data required to calculate the patients? predicted mortality by (APACHE) IV and (SAPS) II scoring systems were collected. Results: A total of hundred (100) patients with organophosphate toxicity who required ICU admission were recruited in the study. The observed mortality following acute organophosphate toxicity in ICU patients was 30% (30 patients). Predicted mortality by APACHE IV and SAPS II scores were 32% and 42% respectively. The area under the receiver operator characteristic (ROC) curves of APACHE IV score (0.978 ? SE 0.012) was better than of SAPS II score (0.796 ? SE 0.045) (p value < 0.05). APACHE IV score of 85 or higher was predictive of mortality with a sensitivity of 93.33% and specificity of 94.29%, as determined by its ROC curve. And a SAPS II score of 50 or higher was predictive of mortality with a sensitivity of 80% and a specificity of 74.29%, as determined by its ROC curve. Thus APACHE IV scoring system had a higher sensitivity and specificity in predicting mortality as compared to SAPS II scoring system. Conclusion: APACHE IV and SAPS II scores calculated within the first 24 h are good prognostic indicators among patients with organophosphate toxicity that required ICU admission, with preference to APACHE IV score. APACHE IV and SAPS II scores above 85 and 50, respectively within the first 24 h are a predictor of poor outcome in patients with acute organophosphate toxicity.

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[Syed Faisal Andrabi, Sadia Lanker, Mehraj-ud-din and Aijaz Ahmed Zargar. (2017); A PROSPECTIVE OBSERVATIONAL STUDY COMPARING THE ACCURACY OF APACHE IV AND SAPS II SCORING SYSTEMS IN PREDICTING THE OUTCOME OF ORGANOPHOSPHATE POISONING PATIENTS ADMITTED TO AN INTENSIVE CARE UNIT IN KASHMIR VALLEY. Int. J. of Adv. Res. 5 (Aug). 655-665] (ISSN 2320-5407). www.journalijar.com

Dr. Syed Faisal Andrabi
Department of Anaesthesia, Govt. Medical College, Srinagar (J&K)

DOI:

Article DOI: 10.21474/IJAR01/5103      
DOI URL: https://dx.doi.org/10.21474/IJAR01/5103

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