Assessment and Validation of an Improved Poisoning Severity and Mortality Scale
Author(s)
Crispin D. J, PharmD1, Adusumilli Pramod Kumar, Ph.D2, Sannidhi Prabhu, PharmD3.
1Student, M S Ramaiah University Of Applied Sciences, Bengaluru, India, 2M S Ramaiah University Of Applied Sciences, Bangalore, India, 3M S Ramaiah University Of Applied Sciences, Bengaluru, India.
1Student, M S Ramaiah University Of Applied Sciences, Bengaluru, India, 2M S Ramaiah University Of Applied Sciences, Bangalore, India, 3M S Ramaiah University Of Applied Sciences, Bengaluru, India.
OBJECTIVES: The objective of this study is to validate the newly developed Poisoning Severity and Mortality Scale (VTSMS) by evaluating its predictive accuracy, reliability, and clinical utility in comparison with existing severity and mortality scoring systems. By applying the scale to poisoning cases in emergency settings, the study aims to improve early risk assessment, optimize triage decisions, and enhance overall patient outcomes. This is particularly significant in developing countries where poisoning remains a major public health concern and rapid clinical decision-making is critical.
METHODS: A prospective observational study was carried out in a tertiary care hospital included patients with confirmed poisoning. Data were collected using structured forms, and each case was assessed using the new severity and mortality scale. Scores were compared with PSS and APACHE IV. Statistical analysis included Kruskal-Wallis, Post Hoc, Receiver operating characteristic or AUC) and Cronbach’s alpha to evaluate validity and internal consistency.
RESULTS: In this study, organophosphorus compounds were the most common poison (36.7%), followed by corrosives (20%) and rodenticides (16.7%). The newly developed Poison Severity and Mortality Scale, pilot-tested on 30 patients, showed excellent internal consistency (Cronbach’s alpha = 0.894). Kruskal-Wallis tests revealed significant differences in severity using PSS (H=28.00, p= 0.00), and VTSMS (H=9.594, p=0.008). Mortality prediction was also significant APACHE IV (H=19.955, p=0.00) and VTSMS (H=8.067, p=0.015). Post Hoc tests supported these findings, and the scale’s AUC was 0.964 for mortality and 0.783 for severity, confirming strong predictive performance.
CONCLUSIONS: The newly developed clinical scoring system, combining real-time severity and mortality prediction, showed comparable sensitivity and specificity to PSS and APACHE IV. It aligned well with actual outcomes in emergency settings, enhancing triage and clinical decisions. Further validation with a larger sample is planned to confirm its reliability and refine the scoring system
METHODS: A prospective observational study was carried out in a tertiary care hospital included patients with confirmed poisoning. Data were collected using structured forms, and each case was assessed using the new severity and mortality scale. Scores were compared with PSS and APACHE IV. Statistical analysis included Kruskal-Wallis, Post Hoc, Receiver operating characteristic or AUC) and Cronbach’s alpha to evaluate validity and internal consistency.
RESULTS: In this study, organophosphorus compounds were the most common poison (36.7%), followed by corrosives (20%) and rodenticides (16.7%). The newly developed Poison Severity and Mortality Scale, pilot-tested on 30 patients, showed excellent internal consistency (Cronbach’s alpha = 0.894). Kruskal-Wallis tests revealed significant differences in severity using PSS (H=28.00, p= 0.00), and VTSMS (H=9.594, p=0.008). Mortality prediction was also significant APACHE IV (H=19.955, p=0.00) and VTSMS (H=8.067, p=0.015). Post Hoc tests supported these findings, and the scale’s AUC was 0.964 for mortality and 0.783 for severity, confirming strong predictive performance.
CONCLUSIONS: The newly developed clinical scoring system, combining real-time severity and mortality prediction, showed comparable sensitivity and specificity to PSS and APACHE IV. It aligned well with actual outcomes in emergency settings, enhancing triage and clinical decisions. Further validation with a larger sample is planned to confirm its reliability and refine the scoring system
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR24
Topic
Clinical Outcomes, Health Service Delivery & Process of Care, Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation
Disease
Alternative Medicine, Mental Health (including addition), No Additional Disease & Conditions/Specialized Treatment Areas