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18552

Prediction of Outcome of Acutely Intoxicated Patients Admitted To Intensive Care Unit in Mansoura-Dakhlia Governorate-Egypt

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Last updated: 22 Jan 2023

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Abstract

Acute poisoning is a frequent cause of admission to emergency departments and intensive care units, as it is considered as an important medical emergency requiring early diagnosis and rapid initiation of therapy. The aim of the present study was to assess characteristics, and outcomes of acutely intoxicated patients who were admitted to ICU.  Also, design a scoring system regarding priority for ICU admission. The present study was carried out on 40 patients who were admitted to intensive care unit of El Mansoura General Hospitals- Egypt during a period of 6 months.  Personal, toxicological, and medical histories, clinical examination and routine investigations were recorded for each patient. At discharge; all patients were reassessed for determination of patients' outcome. The patients were mostly females, single; student aged less than 30 years and from rural areas. The majority of the patients (72.5%) were recovered, 22.5% were died and 5% were referred to hyperbaric oxygen therapy units after carbon monoxide intoxication. Many patients were presented by constricted pupil (45%), respiratory depression (42.5%), altered mental status (42.5%), tachycardia (47.5%), and nausea & vomiting (75%). The highest numbers of cases were poisoned by medicinal drugs (40%) followed by agricultural chemicals (35%). Statistically significant difference between occupation, toxicological amount & frequency, pulse rate, Glasgow coma score, PH & PCO2 and type of poison (zinc phosphide) and patient outcomes was observed.  Although many of the patients' characteristics were significantly associated with patient outcome yet none of them was considered significant predictors for death. So, the suggested scoring system depended mainly on clinical data and simple rapid investigation that may be helpful for rapid assessment of the patients after further validation. We recommend the presence of a channel of communication between the general care centers and the poison control centers for consultation about the protocol of treatment of poisoned patients. Nationwide, a mechanism of communication between the poison centers must be done to benefit from the different expertise and to make a uniform protocol for treatment of poisoned cases to decrease the mortality rate and the burden on hospitals resources. 

DOI

10.21608/ajfm.2016.18552

Keywords

Intensive Care Unit, poison, Outcome, Score, characteristics

Authors

First Name

Merfat

Last Name

Oreby

MiddleName

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Affiliation

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Egypt

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City

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Orcid

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First Name

Aisha

Last Name

Maklad

MiddleName

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Affiliation

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Egypt

Email

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City

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Orcid

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First Name

Nihal

Last Name

Shihab

MiddleName

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Affiliation

Public and Community Medicine Department, Faculty of Medicine, Tanta University, Egypt

Email

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City

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Orcid

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First Name

Hoda

Last Name

Kassem

MiddleName

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Affiliation

Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Egypt

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City

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Orcid

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Volume

26

Article Issue

1

Related Issue

3862

Issue Date

2016-01-01

Receive Date

2018-11-07

Publish Date

2016-01-01

Page Start

140

Page End

150

Print ISSN

1687-1030

Online ISSN

2636-3356

Link

https://ajfm.journals.ekb.eg/article_18552.html

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https://ajfm.journals.ekb.eg/service?article_code=18552

Order

14

Type

Original Article

Type Code

665

Publication Type

Journal

Publication Title

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

Publication Link

https://ajfm.journals.ekb.eg/

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Article

Created At

22 Jan 2023