Development and validation of a risk prediction nomogram for disposition of acute clozapine intoxicated patients to intensive care unit.
| Autor: | Sharif AF; Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.; Department of Clinical Medical Sciences, College of Medicine, Dar Al-Uloom University, Riyadh, Saudi Arabia., Aouissi HA; Scientific and Technical Research Center on Arid Regions (CRSTRA), Biskra, Algeria.; Laboratoire de Recherche et d'Etude en Aménagement et Urbanisme (LREAU), Université des Sciences et de la Technologie (USTHB), Algiers, Algeria.; Environmental Research Center (CRE), Badji-Mokhtar Annaba University, Annaba, Algeria., Kasemy ZA; Public Health and Community Medicine Department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt., Byeon H; Department of Digital Anti-Aging Healthcare (BK21), Inje University, Gimhae, Republic of Korea., Lashin HI; Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt. |
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| Jazyk: | angličtina |
| Zdroj: | Human & experimental toxicology [Hum Exp Toxicol] 2023 Jan-Dec; Vol. 42, pp. 9603271231186154. |
| DOI: | 10.1177/09603271231186154 |
| Abstrakt: | Background: Clozapine is an atypical antipsychotic drug used for the treatment of refractory schizophrenia. It is reported as the most toxic in its class. Using serum clozapine level as a severity indicator is doubtful and unfeasible, particularly in low resourced countries. Methods: This is an extended two-phase retrospective study that utilized medical records of patients diagnosed with acute clozapine intoxication and admitted to Tanta University Poison Control Center, Egypt during the past 6 years. Two hundred and eight medical records were used to establish and validate a nomogram for predicting the need for intensive care unit (ICU) admission in acute clozapine intoxicated patients. Results: A reliable simple bedside nomogram was developed and proved its significant ability to predict the need for ICU admission, with an area under the curve (AUC) of 83.9% and 80.8% accuracy. It encompassed the age of admitted patients (AUC = 64.8%, p = .003), respiratory rate (AUC = 74.7%, p < .001), O Conclusion: There is a need to develop a reliable objective tool predicting the severity and need for ICU admission in acute clozapine intoxication. The proposed nomogram is a substantially valuable tool to estimate ICU admission probabilities among patients with acute clozapine intoxication and will help clinical toxicologists make rapid decisions for ICU admission, especially in countries with low resources. |
| Databáze: | MEDLINE |
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