Eizadi-Mood et al evaluated patients with organophosphate poisoning. They used a modified APACHEII score (MAS) to identify a patient who may have a more severe poisoning. The authors are from Isfahan University of Medical Sciences in Iran.
Patient selection: organophosphate poisoning
Outcome: need for intubation (all patients who did nor require intubation survived; a quarter of patients who required intubation died)
The MAS consists of:
(1) the acute physiology score (APS) without biochemical measures
(2) age points
(3) chronic health points for a nonoperative patient
Data collection:
(1) The data for the acute physiology is collected during the initial 24 hour period after ICU admission.
(2) The worst (most deranged) physiologic value is selected for grading.
Components of the APS:
(1) rectal temperature in °C
(2) mean arterial pressure in mm Hg
(3) heart rate in beats per minute
(4) respiratory rate in breaths per minute
(5) Glasgow coma score (GCS)
Health status is scored if there is a history of severe organ insufficiency OR being immunocompromised.
modified APACHE II score =
= (acute physiology score) + (age points) + (chronic health points)
Interpretation:
• minimum score: 0
• maximum score: 39
• A MAS score >= 5 was predictive of intubation.
• In Figure 1 the Glasgow Coma Score alone performed well, with a score <= 13 associated with intubation.
Performance:
• The area under the ROC curve was 0.89 for predicting intubation.
