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Independent validation of the Tanta University Risk Model for intensive care requirement in acutely poisoned adults
Sabrina Schmoll1, Eva-Carina Heier1, Regina Böll1
1Department of Clinical Toxicology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Objective:
To independently validate the predictive value of the Tanta University Risk Model for intensive care requirement in unselected poisoned patients.
Method:
Retrospective chart review of 293 poisoned patients. The Tanta University Risk Model was calculated as follows: Tanta University Risk Model = -1.966*Glasgow Coma Scale - 0.329*oxygen saturation - 0.212*diastolic blood pressure + 0.27*respiratory rate - 0.33*standard bicarbonate. It was then compared to a composite endpoint indicating an intensive care unit requirement (death in hospital, vasopressors, need for intubation).
Results:
Nineteen of 293 patients had a complicated clinical course as defined by meeting the primary endpoint definition. Receiver operating characteristic analysis revealed the area under the curve to be 0.79 (95% confidence interval 0.73-0.83). A positive Tanta University Risk Model was defined >-73.46. Fifteen out of 84 patients with a positive Tanta University Risk Model had a complicated course, while four of 209 patients with a negative Tanta University risk model had a complicated course (P<0.0001, Fisher's exact test). The negative predictive value of the Tanta University Risk Model was 0.98 (95% confidence interval 0.95-0.99), the sensitivity was 0.79 and that specificity was 0.75.
Conclusion:
Poisoned patients with a negative Tanta University Risk Model score are unlikely to need an intensive care unit level of care.
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