الفهرس 
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Abstract
Drug intoxication is a maJor medical and social problem in developed as well as in developing
countries. In the course of time, the rate of incidence has increased.
With the shift of emphasis in the management of poisoning
from in-patient care to early decontamination and initial stabilization, emergency physicians are
taking a more active role in the care of poisoned patients.
Subjective evaluations of clinical status by individual clinicians may differ in tem1inology, and
even in measurement of the severity of illness. Hence, various descriptive and prognostic
evaluation scales (scoring systems) have been developed during the past three decades.
The primary objective of the present study was:
to record all cases of drug intoxication, to compare between different scoring systems used for
assessment of the severity of acute poisoning, to correlate the different scoring scales to the
most common poisons met with in order to recommend the most reliable sensitive scale to be used in
Egypt and lastly, to evaluate the prognostic role of the different rested scales in the estimation
of the patient’ s outcome.
The study was conducted on all patients admitted to the Poison Unit, development of critical care,
at the Main Alexandria University Hospital during the morning shift over 6
months from the first of December 20V1 to the end of May
2002.
The total number of studied cases was 435 patients. This represented 8.77 %of the total number
of patients admitted to the Poison Unit during the same six months all around the day (n= 4960
cases).
Most of patients were in the age group 15-30 years. The greatest number of poisoning was
encountered during during March The most common type of pmsomng was organophosphorus pesticides.
Illitrate patients represented nearly half the studied cases. The highest frequency of poisoning
was among unemployed and manual workers. The largest number of patients were residents of East and
Middle of Alexandria.
Accidental poisoning represented the largest mode of
poisoning . Most of the patients (80.5%) were suffering from typical symptoms and signs.
Routine investigations were done to all patients and further investigations were done to 20.5% of
cases. Routine therapeutic measures were done to all cases and one third of cases needed further
therapeutic measures.
Patients’follow-up revealed complete recovery in 30.1% of cases, clinical improvement in 64.4% of
cases and two deaths.
Poisoning Severity Score (PSS) has been applied to all poisoned cases. Poisoning was categorized as
mild, moderate, and severe.There was significant relationship between duration of stay in hospital
and PSS, the duration of stay in hospital in the majority of the mild, moderate, and severe PSS
categories ranged between 2-24 hours. A remarkable improvement was seen in most cases of the three
categories with no significant relation between outcome and PSS.
Acute Physiology and chronic Health Evaluation (APACHE II) score was applied to all cases. There
was significant relationship between APACH II score and both duration of stay in hospital and
patient outcome.
Multicentre Study of Poisoning in Children( MSPC) was applied to children less than 10 years (I00
cases). Corrosive and detergents were encountered among 24% of cases. Children in pre-school age
were subjected to poisoning accidents more than any age.
There was no significant relation between MSPC and either the length of stay in hospital or the
outcome. There was no recorded deaths among this studied group.
Glasgow Coma Score (GCS) was applied to patients with altered mental status (120 cases). Mild and
moderate cases of GCS completely recovered while two of the four severe cases died.
In the present study it was found that. none of the studied scores could accurately predict the
patints ·outcome as proved stastically, but GCS assessment was as good predictor for mortality as
was the APACHE II score.