PGI Score: A Promising Alternative to Serum Cholinesterase for Predicting Mortality and Adverse Outcomes in Acute...

Poisoning from organophosphorus compounds (OPCs) poses a significant health issue, especially in countries without proper testing facilities, including cholinesterase (ChE) levels. This study aimed to evaluate the effectiveness of a three-element score called PGI, incorporating pH, the Glasgow Coma Scale (GCS) and impaired systolic blood pressure, in predicting mortality and the need for mechanical ventilation (MV) in acute OPC poisoning. A retrospective cross-sectional study was conducted using medical records of 202 patients admitted for acute OPC poisoning over 3 years. The findings indicated an 11.4% mortality rate and a 25.7% underwent MV. A strong negative correlation was observed between the PGI score and serum ChE level (r = -0.6430, p < 0.0001). The PGI scores of 2 and above were a strong predictor for mortality and MV need. Among PGI components, blood pH < 7.23 was the best mortality predictor, while a GCS < 12 effectively predicted the need for MV (AUC = 0.920). Although the PGI score outperformed PSS in predicting adverse outcomes, it did not show a statistically significant difference compared to serum ChE. The PGI score is a reliable prognostic tool that could replace PSS and serum ChE in predicting the severity of OPC poisoning, as well as the risk of mortality and MV need.