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用于预测急性磷化铝中毒后临床结局的国家早期预警评分2与新中毒死亡率评分系统的比较

The National Early Warning Score 2 versus the New-Poisoning Mortality Score System for Predicting Clinical Outcomes After Acute Aluminum Phosphide Poisoning.

作者信息

Nafea Ola Elsayed, Ibrahim Fatma, Abdelhamid Walaa G

机构信息

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Zagazig Road, inside Zagazig University, Shaibet and Nakareyah, Al-Sharqia Governorate, Zagazig 44519, Egypt.

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Ramses St., Abbassia, Cairo 11566, Egypt.

出版信息

Toxicol Res (Camb). 2025 Jan 8;14(1):tfae230. doi: 10.1093/toxres/tfae230. eCollection 2025 Jan.

Abstract

Acute aluminum phosphide (AlP) poisoning is one of the leading causes of suicide, particularly in the developing world. In cases of scarce and/or high-cost resources, it is advisable to prioritize critically ill patients who will benefit from available resources and improve their prognosis. Despite numerous scores, a dependable, easy-to-use, and quick approach to assessing the degree of poisoning is lacking. This study is designed to compare the prognostic performance of the National Early Warning Score 2 (NEWS2) versus the new-poisoning mortality score system (new-PMS) for predicting the clinical outcomes, including in-hospital mortality, vasopressor use, and mechanical ventilation placement after acute AlP poisoning. This study was a retrospective observational study that included patients with acute AlP poisoning with retrieving the required data from the patients' medical records. A total of 90 acutely AlP-intoxicated patients were enrolled in the study. The in-hospital mortality rate was 42.2%. Additionally, in-hospital mortality, vasopressor use, and mechanical ventilation placement were significantly higher in patients with higher NEWS2 and new-PMS scores. The new-PMS showed excellent prognostic performance, particularly in-hospital mortality prediction; however, NEWS2 demonstrated a more helpful predictive performance compared to the new-PMS particularly for the need for mechanical ventilation and in-hospital mortality, with an area under the curve of 0.991 versus 0.851 and 0.949 versus 0.874, respectively. We concluded that NEWS2 and new-PMS are simple, easily calculated, and lab-independent scoring systems. The NEWS2 is a more effective tracking and triggering tool than the new-PMS in the evaluation of AlP acutely intoxicated patients.

摘要

急性磷化铝(AlP)中毒是自杀的主要原因之一,尤其是在发展中国家。在资源稀缺和/或成本高昂的情况下,建议优先考虑那些将从可用资源中受益并改善其预后的重症患者。尽管有众多评分系统,但仍缺乏一种可靠、易用且快速的中毒程度评估方法。本研究旨在比较国家早期预警评分2(NEWS2)与新中毒死亡率评分系统(new-PMS)在预测急性AlP中毒后临床结局(包括住院死亡率、血管升压药使用和机械通气置入)方面的预后性能。本研究为回顾性观察性研究,纳入急性AlP中毒患者,并从患者病历中获取所需数据。共有90例急性AlP中毒患者纳入本研究。住院死亡率为42.2%。此外,NEWS2和new-PMS评分较高的患者住院死亡率、血管升压药使用和机械通气置入显著更高。new-PMS显示出优异的预后性能,尤其是在住院死亡率预测方面;然而,与new-PMS相比,NEWS2在预测性能方面更具帮助,特别是对于机械通气需求和住院死亡率,其曲线下面积分别为0.991对0.851以及0.949对0.874。我们得出结论,NEWS2和new-PMS是简单、易于计算且不依赖实验室的评分系统。在评估急性AlP中毒患者时,NEWS2是比new-PMS更有效的跟踪和触发工具。

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