Comparison of the Poisoning Severity Score, Sequential Organ Failure Assessment Score, and Acute Physiology and Chronic Health Evaluation II Score with Lactate to assess the outcome in Acute Organophosphorus Poisoning

Abstract

Introduction: Organophosphorus pesticide self-poisoning is estimated to kill around 200000 people yearly. Early
recognition is life-saving as the mortality rates are high following OP Poisoning. Acute Physiology and Chronic
Health Evaluation II Score (APACHE II) Sequential Organ Failure Assessment Score (SOFA), and Poisoning
Severity Score (PSS) with Lactate, are used to evaluate the prognosis.
Materials and Methods: This prospective observational study included 236 individuals with acute OP poisoning
who presented to the emergency department and were hospitalized in the critical care unit and step-down ICU.
PSS, SOFA, and APACHE II scores were calculated at Emergency Department and followed up with the patient
until discharge or death.
Results and Discussion: Patients had a mean age of 32.8 ± 13.4 years and were 49.2% female and 50.8% male.
Out of 236 patients, 22 patients died and 214 were discharged. The best cut-off values for predicting mortality
with PSS, SOFA, and APACHE II scores were 2, 3, and 15, with AUROC of 0.929, 0.970, and 0.984. In addition
to Lactate to the above scores, the AUROC increased to 0.981, 0.993, and 0.992, respectively. The study found
that SOFA and APACHE II scores with Lactate are significantly associated with mortality and have strong
discriminative power in predicting mortality.