Acute colchicine poisoning: prediction of in-hospital mortality at hospital admission using a nomogram. A bicenter retrospective cohort study.

OBJECTIVE

Acute colchicine poisoning is associated with high mortality. Early identification of high-risk patients is crucial for timely intervention. The prognostic value of plasma colchicine concentration (ColC) has not been previously studied. The objective was to develop a nomogram for predicting in-hospital mortality in acute colchicine poisoning using admission ColC and time elapsed since ingestion.

METHODS

We conducted a bicenter retrospective cohort study (2000-2020). Patients with colchicine poisoning from a French toxicology critical care service and an Italian poison control center were included. Validation datasets included data from the registry itself and previously published cases. Logistic regression models were developed using admission ColC (ng/mL), time from ingestion to ColC measurement (h), and in-hospital mortality as the outcome variable.

RESULTS

A nomogram was developed using data from 52 patients (training cohort) and validated in 3 independent testing cohorts (n = 25, 13, and 16, respectively). In this retrospective study, the nomogram demonstrated potential for discriminating patients at greater risk.

CONCLUSIONS

An exploratory nomogram for early risk stratification of mortality after colchicine poisoning is presented. Clinical implementation requires prospective multicenter validation with adequate statistical power.