Triage vital signs predict in-hospital mortality among emergency department patients with acute poisoning: a case control study

Background: To document the relationship between triage vital signs and in- hospital mortality among emergency department (ED) patients with acute poisoning. Methods: Poisoning patients who admitted to our emergency department during the study period were enrolled. Patient's demographic data were collected and odds ratios (OR) of triage vital signs to in-hospital mortality were assessed. Receiver operating characteristic curve was used to determine the proper cut-off value of vital signs that predict in-hospital mortality. Logistic regression analysis was performed to test the association of in-hospital mortality and vital signs after adjusting for different variables. Results: 997 acute poisoning patients were enrolled, with 70 fatal cases (6.7%). A J-shaped relationship was found between triage vital signs and in-hospital mortality. ED triage vital signs exceed cut-off values independently predict in-hospital mortality after adjusting for variables were as follow: body temperature < 36 or > 37 degrees C, p < 0.01, OR = 2.8; systolic blood pressure < 100 or > 150 mmHg, p < 0.01, OR: 2.5; heart rate < 35 or > 120 bpm, p < 0.01, OR: 3.1; respiratory rate < 16 or > 20 per minute, p = 0.38, OR: 1.4. Conclusions: Triage vital signs could predict in-hospital mortality among ED patients with acute poisoning. A J-curve relationship was found between triage vital signs and in-hospital mortality. ED physicians should take note of the extreme initial vital signs in these patients.