Development of a practical prediction scoring system for severe acute organophosphate poisoning.
Acute organophosphorus poisoning (AOPP) is a serious public health issue, especially in the rural areas. This study was designed to establish a scoring system to assess the risk of cases with severe AOPP. A retrospective cohort study was conducted at two independent hospitals. The derivation cohort included 444 patients with AOPP and the validation cohort included 274 patients. A risk score for patients with severe AOPP was developed. The rates of severe AOPP cases were 20.7% and 20.1% in the derivation and validation cohorts, respectively. A scoring system for severe AOPP risk was developed that included: (1) age >50 years, (2) white blood cell count of >15 × 109 /L, (3) plasma cholinesterase of <360 U/L, (4) plasma albumin of <35 g/L, (5) blood pH <7.3, and (6) lactic acid >3.0 mmol/L. The predicted score in severe cases of AOPP had good accuracy in both the derivation (area under the receiver operating characteristic curve [AUC] 0.88, 95% confidence interval [CI], 0.85-0.92) and validation cohorts (AUC 0.83, 95% CI, 0.77-0.90). A practical bedside prediction scoring system was developed for patients with severe AOPP. The routine use of this scoring system could rapidly assist in identifying patients at higher risk who require more intensive care or transfer to a larger better-equipped hospital.
['Dong|Ning|N|0000-0002-1155-2631', 'Liu|Junlan|J|', 'Wang|Zhihao|Z|', 'Gao|Nan|N|', 'Pang|Li|L|0000-0003-0561-4100', 'Xing|Jihong|J|']
D000328:Adult D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D002681:China D002802:Cholinesterases D015331:Cohort Studies D005260:Female D006801:Humans D019344:Lactic Acid D007958:Leukocyte Count D008297:Male D008875:Middle Aged D062025:Organophosphate Poisoning D010949:Plasma D011237:Predictive Value of Tests D012372:ROC Curve D012189:Retrospective Studies D018570:Risk Assessment D012307:Risk Factors D012709:Serum Albumin D055815:Young Adult
scoring system acute organophosphate poisoning public health rural areas risk prediction