Shively et al identified factors predictive of a severe outcome following acute salicylate poisoning. The authors are from Mount Sinai, New York University and Elmhurst Hospital Center in New York City.
Patient selection: acute salicylate poisoning
Criteria for severe outcome: acidemia, hemodialysis or death. Acidemia defined as pH < 7.3 or serum bicarbonate < 16 mmol/L.
Predictors of severe outcome on multivariate analysis:
(1) age (odds ratio 1.13 per increase year). The mean age with severe outcome was 46 with SD 23.
(2) respiratory rate with tachypnea (odds ratio 1.29 per increase respiration). The mean respiratory rate was 22.4 breaths per minute with SD 7.
A blood lactate >= 2.25 mmol/L was associated with a worse outcome.
The initial serum salicylate concentration was not significant in the prediction of a severe outcome.
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