Persson H E, Sjöberg G K, Haines J A, Pronczuk de Garbino J
Swedish Poisons Information Centre, Karolinska Hospital, Stockholm, Sweden.
J Toxicol Clin Toxicol. 1998;36(3):205-13. doi: 10.3109/15563659809028940.
A standardized and generally applicable scheme for grading the severity of poisoning allows a qualitative evaluation of morbidity and facilitates comparability of data. Working from a simple grading scale proposed by the European Association of Poisons Centres and Clinical Toxicologists, a Poisoning Severity Score has been developed jointly with the International Programme on Chemical Safety and the European Commission.
The Poisoning Severity Score has been elaborated, tested, and gradually revised during a project running 1991-1994. Fourteen poisons centers from various countries have participated. Each center independently graded 371 cases of acute poisoning by ten different toxic agents. The data were then analyzed and compared.
The concordance in grading the severity increased during the study period, and in the last phase there was an acceptable concordance among centers in 80% or more of the cases. Given the condition and quality of the original case records, this result was considered satisfactory and agreement was reached on the scoring scheme presented here. The Poisoning Severity Score grades severity as (0) none, (1) minor, (2) moderate, (3) severe, and (4) fatal poisoning. It is intended to be an overall evaluation of the case, taking into account the most severe clinical features. Use of the Poisoning Severity Score normally requires a follow-up of all cases, but may be used on admission or other times during the course of poisoning if this is clearly stated when data are presented.
A Poisoning Severity Score has been developed and found applicable for grading the severity of poisoning. It is foreseen that the Poisoning Severity Score will meet the expectations and be used in practice, but its future use and evaluation may result in some further revision and refinement.
一种标准化且普遍适用的中毒严重程度分级方案能够对发病率进行定性评估，并有助于数据的可比性。在欧洲毒物中心和临床毒理学家协会提出的简单分级量表基础上，与国际化学品安全规划署及欧盟委员会联合制定了中毒严重程度评分。
中毒严重程度评分在1991 - 1994年的一个项目中进行了详细阐述、测试并逐步修订。来自不同国家的14个毒物中心参与其中。每个中心独立对10种不同毒物导致的371例急性中毒病例进行分级。然后对数据进行分析和比较。
在研究期间，分级的一致性有所提高，在最后阶段，各中心在80%或更多病例中达成了可接受的一致性。鉴于原始病例记录的条件和质量，该结果被认为是令人满意的，并且就此处提出的评分方案达成了一致。中毒严重程度评分将严重程度分为（0）无、（1）轻度、（2）中度、（3）重度和（4）致命中毒。它旨在综合考虑最严重的临床特征对病例进行全面评估。使用中毒严重程度评分通常需要对所有病例进行随访，但如果在提交数据时明确说明，也可在中毒过程中的入院时或其他时间使用。
已制定出中毒严重程度评分，并发现其适用于中毒严重程度分级。预计中毒严重程度评分将满足期望并在实践中得到应用，但它未来的使用和评估可能会导致一些进一步的修订和完善。
