Assessment of respiratory rate-oxygenation index (ROX), HACOR score and the C-reactive protein for prediction of mechanical ventilation and mortality in acutely intoxicated patients.

BACKGROUND

Acute respiratory toxicity is a common presenting emergency in acutely poisoned patients. Unpredictable respiratory deterioration can occur regardless of the on-admission patients' stable state, leading to increased morbidity and mortality. This study aimed to evaluate the respiratory rate-oxygenation (ROX) index, heart rate, acidosis, consciousness, oxygenation and respiratory rate (HACOR) score and C-reactive protein (CRP) as predictors of mechanical ventilation (MV) in poisoned patients.

METHODS

This prospective study was conducted on poisoned patients with acute respiratory failure presented to the Poison Control Center-Ain Shams University Hospitals (PCC-ASUHs). Upon admission, all patients had their ROX index, HACOR score and CRP level measured at the time of admission and at 24 hours.

RESULTS

Seventy-two patients were enrolled in the study, where forty-one cases were mechanically ventilated. The initial ROX index was significantly lower in the mechanically ventilated group with a cut-off ≤ 18.85 at AUC (0.74). The 24-hour ROX index, HACOR score and CRP level were predictors of mechanical ventilation need at AUC (0.97, 0.94, 0.85, respectively).

CONCLUSION

It was concluded from this study that the initial and 24-hour ROX index, 24-hour HACOR and CRP level can be predictors of MV in poisoned patients.