Comparison of the new-Poisoning Mortality Score and the Modified Early Warning Score for predicting in-hospital mortality in patients with acute poisoning

Sijin Lee ¹, Su Jin Kim ¹, Kap Su Han ¹

⁰Department of Emergency Medicine, College of Medicine, Korea University Anam Hospital, Seoul, Republic of Korea.

Clinical Toxicology (Philadelphia, Pa.) +

|

February 29, 2024

View abstract on PubMed

Summary

The new-Poisoning Mortality Score effectively predicts in-hospital deaths in acute poisoning cases. This validated score outperforms the Modified Early Warning Score, improving clinical decisions and patient care.

Area Of Science

Emergency Medicine
Toxicology
Clinical Epidemiology

Background

Acute poisoning presents diagnostic challenges due to diverse toxins and patient presentations.
The novel Poisoning Mortality Score (PMS) was developed to predict in-hospital mortality in acute poisoning.
External validation is crucial to confirm the PMS's utility and compare it with existing tools.

Purpose Of The Study

To externally validate the performance of the new-Poisoning Mortality Score.
To compare the predictive accuracy of the PMS against the Modified Early Warning Score (MEWS).

Main Methods

Retrospective analysis of 16,570 patients from the 2019-2020 Korea Center for Disease Control and Prevention Injury Surveillance Cohort.
Statistical comparison of PMS and MEWS using discrimination (AUC, sensitivity, specificity, accuracy) and calibration (Hosmer-Lemeshow test, calibration curves).
Evaluation of performance across different toxic substances and mortality indices.

Main Results

The PMS demonstrated superior predictive performance compared to MEWS.
PMS achieved higher AUC (0.947 vs. 0.800), sensitivity (0.863 vs. 0.667), specificity (0.912 vs. 0.817), and accuracy (0.911 vs. 0.814).
The PMS showed better concordance between predicted and observed mortalities and consistent strong performance across subgroups.

Conclusions

The new-Poisoning Mortality Score is a validated and effective tool for predicting in-hospital mortality in acute poisoning patients.
The PMS offers superior performance over MEWS, aiding emergency department clinical decision-making.
Implementation of the PMS can enhance patient management strategies in acute poisoning cases.

Keywords:

Modified Early Warning Score Mortality comparison new-Poisoning Mortality Score poisoning predictive model