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Hunter Serotonin Toxicity Criteria

Purpose: To identify serotonin toxicity using decision rules developed at the Hunter Area Toxicity Service in Australia.

Description

Dunkley et al developed decision rules for the diagnosis of serotonin toxicity based on CART (Classification and Regression Tree) analysis. The authors are from the Hunter Area Toxicology Service (HATS) at Newcastle Mater Misericordiae Hospital in New South Wales, Australia.


Rules for serotonin toxicity in a patient with exposure to a serotonergic agent - presence of one or more of the following:

(1) spontaneous myoclonus present

(2A) inducible clonus and agitation present

(2B) inducible clonus and diaphoresis present

(3A) ocular clonus and agitation present

(3B) ocular clonus and diaphoresis present

(4) tremor and hyperreflexia present

(5A) hypertonic and temperature > 38°C and ocular clonus

(5B) hypertonic and temperature > 38°C and inducible clonus

 

If the rules are all negative, then the patient does not have serotonergic toxicity.

 

Performance:

• The criteria have a higher sensitivity (84%) and marginally higher specificity (97%) as compared to the Sternbach criteria.


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Specialty

Objective

ICD-10