This study aimed to assess the severity of poisoning, various scoring systems, including Sequential Organ Failure Assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II), Simplified Acute Physiology score (SAPS II), Modified APACHE II, and poisoning severity score (PSS) were used. In this study, we compared the predictive value of these scoring systems on the outcome of pesticide-poisoned patients. Methods: This is a cross-sectional study of pesticide-poisoned patients (140 patients) who were admitted to the intensive care unit (ICU) of Khorshid Hospital, Isfahan, Iran, between January 2015 and 2019. The area under the receiver operating characteristic (AUC) curve and the predictive value of scoring systems were compared. Findings: Poisoning was higher in the male population (72.8%). The causes of poisoning were paraquat, (38.6%), aluminum phosphide, (32.1%), and organophosphate, (29.3%). The mean age of the patients was 33.9 years. Most patients (79.3%) attempted suicide. The mortality rate was 46.43%. The mean of “SOFA score,” “APACHE II,” “SAPS II,” “Modified APACHE II,” and “PSS” was 5.9; 15.7; 30.02; 15.8; and 1.9, respectively. There was a significant difference in the mean of all scoring systems for outcome prediction. Among all scoring systems, the SAPS II score with the cutoff point (16.5) had the best criteria for outcome prediction (AUC (0.831 ± 0.037), sensitivity (83.1%, 95% confidence interval [CI]: [71.7–91.2]), specificity (75.7%, 95% CI: [64.3–84.9]), positive predictive values (75.0%, 95% CI: [66.4–82.0]), negative predictive values (83.6%, 95% CI: [74.5–89.9]). Conclusion: The SAPS II scoring system may be a suitable indicator for outcome predictions in pesticide-poisoned patients in the ICU.

Background: Using different scores to predict the outcome of patients and determine the severity of their illness could be effective in making better clinical decisions and helping patients. The purpose of this study is to determine the predictive value of the National Early Warning score (NEWS) and Modified Early Warning score (MEWS) of in-hospital mortality in patients with a suicide attempt. Methods: In a diagnostic study, we included 453 patients with suicide attempts in the poisoning unit and Intensive Care Unit (ICU) poisoning unit of Sina Hospital from December 2019 to September 2021. Patients’,vital signs and level of consciousness were recorded and then analyzed by statistical methods. Results: The Mean±, SD of patients’,age was 31. 82±, 12. 28 and the mortality rate was 7. 7%. The median (25%-75%) of NEWS and MEWS in all patients was 4(2-7) and 2(1-3), respectively. Based on the Receiver Operating Characteristic (ROC) curve of NEWS, the Area Under The Curve (AUC) (CI95%), standard error, and cut off point were 0. 915(0. 876-0. 995), 0. 020, and 7. 5 respectively (85% sensitivity and 81% specificity) (P˂, 0. 001). The results of MEWS based on Receiver Operating Characteristic (ROC) curve were 0. 87 (0. 805-0. 932), 0. 033, and 3. 5 respectively (74% sensitivity and 84% specificity) (P˂, 0. 001). Conclusion: Based on our study results, we concluded that in hospitalized patients with suicide attempts, the accuracy of NEWS in predicting hospital mortality is higher than MEWS.

To evaluate the processes of care and outcomes of injured patients, many different models have been devised and "Trauma and Injury severity score" and "A severity Characterization of Trauma" score have been among the most widely used models. We conducted this study to determine the effectiveness of these systems of evaluation to our setting in Iran, which is substantially different from the North American trauma centers, where these models were developed. Using our data registry on trauma patients, we derived new coefficients for Trauma and Injury severity score and A severity Characterization of Trauma scoring systems to calculate the probability of survival of patients. Finally, we determined the calibration and discrimination of the models by calculating the Hosmer-Lemeshow statistic and the area under the receiver operating characteristic curve. In our study, TRISS and A severity Characterization of Trauma provided an adequate estimation of the survival probability and both models showed better discrimination in penetrating trauma. Discrimination in blunt injuries was a little lower, yet satisfactory. In pediatric patients the discrimination was also good and A severity Characterization of Trauma had a better performance. Both models can be used reliably to predict outcome of trauma patients in our setting.

Background: Pesticide poisoning is very common in Tunisia. Various factors are involved in the analysis of the clinical presentations and the severity of this condition. Major factors are the chemical nature of the pesticides and the quantity entered the body. Methods: This is a retrospective study, reporting the pediatric cases that presented to us with signs and symptoms of pesticide poisoning. Fifty cases pesticide poisoning were admitted to the hospital between January 2013 and October 2016. Results: A total of 50 pediatric cases were included in this study with the mean age of 3 years and 4months. The poisoning was accidental in 49 cases and self-inflicted in one, with the mode being oral (N=45), respiratory (N=2) and cutaneous (N=3). The average duration of hospital care for these patients was 2 hours and 30 minutes (range: 30 min-24 hr). The clinical manifestations of poisoning noted were due to muscarinic and nicotinic receptors inhibition. Upon clinical examination, 29 patients had no pesticide in the gastric lavage 􀏐 luid and urine and demonstrated no abnormal cholinesterase activity. The therapeutic management was mainly symptomatic with antidote medications prescribed (atropine and oxime). All patients had favorable outcomes and no death occurred. Conclusion: This study demonstrated the frequency of pesticide poisoning in a pediatric setting and the importance of early management. Optimal therapeutic approaches were evaluated, demonstrating that prevention still remains the best solution in such cases.