Emergency risk stratification for early respiratory failure in acute pesticide poisoning: a nomogram prediction model

This simple four-variable nomogram provides accurate early risk assessment for respiratory failure in acute pesticide poisoning, offering superior discrimination over standard NEWS. The proposed risk stratification framework can support ED triage decisions regarding monitoring intensity and critical care resource allocation. Key messages What is already known on this topic: Existing severity scores (e.g. PSS, NEWS) are either too complex for rapid triage or lack specificity for the toxicological and metabolic risks of acute pesticide poisoning. What this study adds: This study develops and internally validates a simple four-variable nomogram (decreased level of consciousness, organophosphate poisoning, arterial pH, serum creatinine) that predicts early respiratory failure with significantly better discrimination than the standard NEWS score. How this study might affect research, practice or policy: By providing a practical three-tier risk stratification framework, this bedside tool may support emergency physicians in optimizing monitoring intensity and critical care resource allocation, pending external validation.