PREDICTORS OF MORTALITY IN ACUTELY INTOXICATED PATIENTS ADMITTED TO INTENSIVE CARE UNIT IN MENOUFIA UNIVERSITY HOSPITAL

Background:
Acute poisoning is a major cause of suicide and public health problem all over the world. Evaluation of the morbidity and outcome of admitted patients can assess the efficacy of treatment, making it possible to take better decisions and to further improve quality of care.
Objectives: The present study was aimed to study multiple factors associated with fatal poisoning of the patients admitted to ICU and to assess APACHE II Scoring System in prediction of poisoning outcome. Material and Methods: in this prospective study, from January 2019 to December 2019, critical patients with acute poisoning admitted to ICU, Menoufia University hospitals-Egypt were enrolled into this study. Data including demographic features, clinical and lab findings, Acute Physiology and Chronic Health Evaluation (APACHE II) at admission, mode and route of poisoning, the need for mechanical ventilation or vasoactive agents, duration of mechanical ventilation and ICU stay were documented, collected and analyzed by the relevant statistical methods. All patients were studied till death or discharge from the ICU. Results: During the study period, 152 out of 1745 patients admitted to the Menoufia poisoning control center (MPCC) were admitted to the ICU. Out of them, 54 died and 98 survived. The majority were in age group (20-40) years. Females were (62.5%) of the total cases. Intentional poisoning was predominant. Pesticides were the most commonly employed poison including aluminium phosphide and organophosphorus compounds. Aluminium phosphide was highly toxic. High APACHE II score, mechanical ventilation and inotropic support were associated with high mortality. Conclusion: Some findings were correlated with outcome in acute poisoning and can be used as guidance for risk assessment and treatment planning of the patients. The higher the APACHE II score, the more serious the condition becomes. Proper counseling to counteract the stressful situations to reduce fatalities. In addition, some policy should be applied to control the easy availability of poisons in the society.