lntoxicacão por organofosforados - Avaliação prognóstico em 143 doentes

Abstract

Organophosphate pesticides intoxication is still a major cause of death at ICUs. From our experience, gravity scores such as APACHE II, SAPS I or TISS although useful in this pathology, are not totally effective in predicting a fatal ou­tcome. With the purpose of improving the predictive power of those scores, we conducted a retrospective study of 143 patients admitted at U.U.M.. Using appropriate statistical methods, two gravity scores were built: the first one used 16 items obtained at admittance to the ICU, and the second one was based upon 13 clinical and therapeutic items obtained during the time spent at the ICU. Patients were stratified in three risk groups according to the individual score result (Scorel <19 - mortality: 4%, Scorel between 19 and 33 - mortality: 30%; Score1 >33 - mortality: 94%). Two groups of high prognostic value for a fatal outcome ( sensitivity: 93% and specificity: 87%) were defined by the use ofthe second score. Score2 (Score2 <14 - mortality: 4%; Score2 >= 14 mortality: 78%). The use of both scores (1 and 2) revealed a more accurate predictive power of a fatal outcome than APACHE II, SAPS I or TISS. Score2 strengthened the predictive power of Sco­rd, mainly on those patients with intermediate risk prognosis at admission. Using Scores 1 and 2 altogether, we found a predictive result of ou­tcome in 89% of all patients.