Independent validation of the Tanta University Risk Model for intensive care requirement in acutely poisoned adults
Sabrina Schmoll, Eva-Carina Heier, Regina Böll, Tobias Zellner, Katrin Romanek, Florian Eyer, Christian Rabe, Stefanie Geith
Abstract
Objective To independently validate the predictive value of the Tanta University Risk Model for intensive care requirement in unselected poisoned patients.Method Retrospective chart review of 293 poisoned patients. The Tanta University Risk Model was calculated as follows: Tanta University Risk Model = −1.966*Glasgow Coma Scale − 0.329*oxygen saturation − 0.212*diastolic blood pressure + 0.27*respiratory rate − 0.33*standard bicarbonate. It was then compared to a composite endpoint indicating an intensive care unit requirement (death in hospital, vasopressors, need for intubation).Results Nineteen of 293 patients had a complicated clinical course as defined by meeting the primary endpoint definition. Receiver operating characteristic analysis revealed the area under the curve to be 0.79 (95% confidence interval 0.73–0.83). A positive Tanta University Risk Model was defined >−73.46. Fifteen out of 84 patients with a positive Tanta University Risk Model had a complicated course, while four of 209 patients with a negative Tanta University risk model had a complicated course (P<0.0001, Fisher’s exact test). The negative predictive value of the Tanta University Risk Model was 0.98 (95% confidence interval 0.95–0.99), the sensitivity was 0.79 and that specificity was 0.75.Conclusion Poisoned patients with a negative Tanta University Risk Model score are unlikely to need an intensive care unit level of care.