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19482

Poisoning Severity Score as a Predictor of Cardiotoxicity Induced by Anticholinesterase Pesticides, Digoxin and Beta Blockers

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Last updated: 22 Jan 2023

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Abstract

Poisoning and fatalities by cardiotoxic agents represent a challenging health problem in Egypt. An important action to combat this problem is to predict or, at least, early diagnose cardiac involvement. To do so, the clinician needs both bedside skills and appropriately selected laboratory testing. The Poisoning Severity Score (PSS) has been evaluated in one study which found it to be useful in identifying serious and complicated cases of poisoning. The aim of this study was to investigate effectiveness of the PSS in predicting cardiotoxicity, as well as correlations of different demographic, exposure, clinical and laboratory findings to cardiotoxicity. Methodology: Over a period of 4 months, we investigated 59 patients with anticholinesterases (n=28), digoxin (n=17), and beta-blocker toxicities (n=14) admitted to Poison Control Center of Ain Shams University Hospitals (PCCA), Cairo, Egypt, in addition to 16 healthy controls. For each, age, sex, mode of exposure, compound involved, time elapsed between exposure and admission, length of hospital stay, clinical, laboratory, and electrocardiographic findings were recorded. Also, PSS was calculated. Results: Female gender, lag between exposure and admission, length of ICU stay, and total length of hospital stay were significantly correlated to the severity of cardiotoxicity. Vomiting, metabolic acidosis, respiratory alkalosis, and PSS were independent predictors of cardiotoxicity. A PSS of 2 had a sensitivity of 88% and a specificity of 64.7% in predicating cardiotoxicity. Conclusion: Implication of PSS in prediction and early diagnosis of cardiotoxicity is easy, available, cheap, and reliable, whatever the type of toxic exposure.

DOI

10.21608/ajfm.2012.19482

Authors

First Name

Ayman

Last Name

Zaaqoq

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Affiliation

Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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First Name

Hany

Last Name

Gamaluddin

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Affiliation

Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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Orcid

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First Name

Enas

Last Name

El-Taftazani

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Affiliation

Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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First Name

Gamal

Last Name

Al-Sayed

MiddleName

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Affiliation

Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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Orcid

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First Name

Samar

Last Name

Ahmed

MiddleName

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Affiliation

Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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Volume

19

Article Issue

2

Related Issue

3964

Issue Date

2012-06-01

Receive Date

2018-11-18

Publish Date

2012-06-01

Page Start

53

Page End

66

Print ISSN

1687-1030

Online ISSN

2636-3356

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https://ajfm.journals.ekb.eg/article_19482.html

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https://ajfm.journals.ekb.eg/service?article_code=19482

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Original Article

Type Code

665

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Journal

Publication Title

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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

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Article

Created At

22 Jan 2023