Less is more: Evaluating the effectiveness of simplified two and three-element scores for predicting unfavorable outcomes in acute toxic alcohol exposure: A multi-center study

Toxic alcohols are readily available in multiple household products. Although acute toxic alcohol exposure is less frequently reported, it results in severe consequences. This study aimed to evaluate the effectiveness of the three elements score, PGI]pH, Glasgow Coma Scale (GCS), and Impaired systolic blood pressure (SBP)] score and its two elements modified PG (pH and GCS) score, in identifying high-risk alcohol-exposed patients, compared to the multivariable conventional poison severity score (PSS). This cross-sectional study was conducted among 80 patients admitted to two poison control centers over a five-year period. These patients were exposed to toxic alcohols, including methanol, glycols, and propanol. The PGI/PG scores were derived retrospectively by assigning one point for every adopted variable, including pH < 7.25, GCS < 13, and impaired SBP < 90 mmHg. Patients with unfavorable outcomes constituted 27.5 %, where 17.5 % underwent hemodialysis (HD), 6.3 % developed blindness, 5 % needed mechanical ventilation (MV), and 2.5 % died. Patients with unfavorable outcomes demonstrated significantly higher PSS, PGI, and PG scores (p < 0.05). PSS was superior in predicting blindness only. PGI and PG scores demonstrated higher capabilities for predicting unfavorable outcomes, as well as the need for HD and MV. PG achieved the highest areas under curve as an unfavorable outcome's predictor (0.889), need for HD (0.819), and MV (0.993). The PGI and PG scores could serve as simple and reliable predictors of unfavorable outcomes, including the need for HD and MV among patients poisoned with acute toxic alcohol exposure.