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The National Early Warning Score 2 versus the New-Poisoning Mortality Score System for Predicting Clinical Outcomes
Ola Elsayed Nafea1, Fatma Ibrahim1, Walaa G Abdelhamid2
1Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Zagazig Road, inside Zagazig University, Shaibet and Nakareyah, Al-Sharqia Governorate, Zagazig 44519, Egypt.
None:
Acute aluminum phosphide (AlP) poisoning is one of the leading causes of suicide, particularly in the developing world. In cases of scarce and/or high-cost resources, it is advisable to prioritize critically ill patients who will benefit from available resources and improve their prognosis. Despite numerous scores, a dependable, easy-to-use, and quick approach to assessing the degree of poisoning is lacking. This study is designed to compare the prognostic performance of the National Early Warning Score 2 (NEWS2) versus the new-poisoning mortality score system (new-PMS) for predicting the clinical outcomes, including in-hospital mortality, vasopressor use, and mechanical ventilation placement after acute AlP poisoning. This study was a retrospective observational study that included patients with acute AlP poisoning with retrieving the required data from the patients' medical records. A total of 90 acutely AlP-intoxicated patients were enrolled in the study. The in-hospital mortality rate was 42.2%. Additionally, in-hospital mortality, vasopressor use, and mechanical ventilation placement were significantly higher in patients with higher NEWS2 and new-PMS scores. The new-PMS showed excellent prognostic performance, particularly in-hospital mortality prediction; however, NEWS2 demonstrated a more helpful predictive performance compared to the new-PMS particularly for the need for mechanical ventilation and in-hospital mortality, with an area under the curve of 0.991 versus 0.851 and 0.949 versus 0.874, respectively. We concluded that NEWS2 and new-PMS are simple, easily calculated, and lab-independent scoring systems. The NEWS2 is a more effective tracking and triggering tool than the new-PMS in the evaluation of AlP acutely intoxicated patients.
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