Predicting outcome in acute cardiotoxicity based on Glasgow coma scale (GCS) and modified APACHE II score (MAS)

Abstract

Introduction: Acute cardiotoxicity patients can have adverse effects that may lead to intensive care unit (ICU) admission. Because of limited ICU beds, triage and stratification of cases into different groups according to survival is a must nowadays. Many scoring systems have been as a tool for triage and improve ICU quality management. This study aims to evaluate the role of GCS (Glasgow coma scale) and MAS (Modified Acute Physiology And Chronic Health Evaluation) as effective scoring system in predicting mortality in acute cardiotoxicity Methods: A prospective study was carried on 100 patients with acute cardiotoxicity by drugs and toxins known to cause cardiac injury admitted to Sohag Hospitals. Results 94% of patients had survived 4 of which discharged with complication. By ROC curve analysis to assess the predictor of outcome of acute cardiovascular toxicity, it was found that MAS score at cut off value > 11.5 had sensitivity 100% and specificity 74.5%, GCS at cut off < 9.5 had sensitivity 100% and specificity 72.3%.The accuracy rate of GCS was (92.4%) while that of MAS was (90.8%). Conclusion: GCS and MAS can be used as simple predictor tools of mortality in acute cardiotoxicity. Recommendation: GCS and MAS may be used as simple triage tools in acute cardiotoxicity patients in ICU to improve quality management and utilizing hospital resources.