The Prognostic Value of Admission AVPU and Glasgow Coma Scales in Acute Drug Poisoning Patients

Background: Glasgow coma scale (GCS) was originally designed to be used in standardizing the assessment of conscious level in head trauma patients. However, GCS is now widely used in emergency departments as an indicator of the CNS statu s in patients regardless of their primary etiology. Alongside with GCS, AVPU scale (an acronym from “alert, verbal, painful and u nresponsive”) is a simpler system which can be used to measure and reco rd a patient’s level of consciousness. Therefore, the study in vestigated the values of admission GCS and AVPU as outcome predictor in mixed poisoned patients. Method: A retrospective study in toxicology unit was p erformed on patients presented with mixed poisoning. Ou tcomes were recorded as patient necessity of GI decontamination, leng th of neurology observation and the length of hospital stay in toxicology unit. Results: There was longer duration of hospital stay in toxicology unit and requirement of neurology observation in patients presented with lower GCS score (whether using cut-off p oint at 13 or 8). Similar findings were observed in AVPU s cale analysis. Majority of patients did not require GI decontamination in both GCS score and AVPU analysis. However, it did not show any statistical significance (P > 0.05) in both group analyses. Conclusion: Admission GCS score and AVPU scale both are not good indicators to predict severity in acute mixed poisoning patients. However, the use of AVPU scale may not be infer ior to the use of GCS score in assessing acute poisoning p atients.