Journal of Clinical Toxicology
Open Access

Abstract

Critical Score as a Predictor for Progression of Tramadol Intoxication

Seham Fouad, Nahla Hassan, Nabil Nassief, Fathia El- Halawany and Rania Hussien

The rate of tramadol abuse in Egypt is becoming disastrous in spite of adding it to the narcotics list by the Egyptian government in the recent years. This study aims to construct a predictive model for acute tramadol intoxicated cases. This study was conducted on tramadol intoxicated patients attending the emergency department of the Poison Control Center (PCC), Ain Shams University hospitals during the period from 1/10/2010 to 30/9/2011. All the patients were subjected to history taking, clinical examination, laboratory investigations, electrocardiography (ECG) and calculation of the APACHE II score. The current study constructs and assesses a new score for prediction of prognosis of tramadol intoxicated patients from clinical and laboratory results obtained from the most predictive parameters affecting the APACHE II score and the most important variables that differentiate best between the studied groups. The area under the ROC curve for the predictive score was 0.996, the best cut-off point was 26 with a sensitivity of 98.46% and specificity of 95.62%.Conclusion: patients with predictive score >26 on admission considered as mild cases while patients with predictive score<26 on admission considered as moderate or severe cases.