Han et al reported a new poisoning mortality score (new PMS) for a patient in the Emergency Department with acute poisoning. The authors are from Korea University in Seoul.
Patient selection: poisoned patient in the Emergency Department
Outcome: mortality
Parameters:
(1) age in years
(2) sex
(3) intent of poisoning
(4) route of poisoning
(5) category of substances (Table 2, page 5)
(6) systolic blood pressure in mm Hg
(7) heart rate in beats per minute
(8) respiratory rate in breaths per minute
(9) body temperature in °C
(10) mental status (AVPU)
|
Parameter |
Finding |
Points |
|
age in years |
< 40 years |
0 |
|
|
40 to 59 years |
7 |
|
|
60 to 69 years |
12 |
|
|
70 to 79 years |
16 |
|
|
>= 80 years |
19 |
|
sex |
female |
0 |
|
|
male |
4 |
|
intent |
unintentional |
0 |
|
|
intentional |
8 |
|
|
unknown |
9 |
|
route of exposure |
dermal, ocular, contact |
0 |
|
|
oral |
8 |
|
|
inhalation |
5 |
|
category |
A (range of medical drugs and reagents) |
0 |
|
|
B (range of medical drugs, street drugs) |
11 |
|
|
C (alcohols, heavy metal, hydrocarbon, chlorine) |
15 |
|
|
D (rodenticide, unspecified insecticide, pyrethroid, glyphosate, unspecified pesticide, unspecified acid or alkali) |
21 |
|
|
E (glacial acetic acid, organophosphate, carbamate) |
27 |
|
|
F (paraquat) |
47 |
|
|
G (carbon monoxide or unspecified gas) |
15 |
|
|
H (natural toxins) |
12 |
|
systolic blood pressure |
>= 100 |
0 |
|
|
70 to 99 |
6 |
|
|
< 70 |
15 |
|
heart rate |
>= 160 |
8 |
|
|
120 to 159 |
4 |
|
|
70 to 119 |
0 |
|
|
30 to 69 |
1 |
|
|
< 30 |
?? (use 8) |
|
respiratory rate |
<= 11 |
5 |
|
|
12 to 24 |
0 |
|
|
>= 25 |
5 |
|
body temperature |
< 39°C |
0 |
|
|
>= 39°C |
6 |
|
mental status |
alert |
0 |
|
|
response to verbal |
5 |
|
|
response to pain |
8 |
|
|
unresponsive |
16 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 137 (counting only 1 substance)
• The higher the score the more severe the poisoning.
|
Total Score |
Risk Group |
|
0 to 27 |
very low |
|
28 to 40 |
low |
|
41 to 55 |
intermediate |
|
>= 56 |
high |
Performance:
• The authors report an area under the ROC curve of 0.94.
