Clinical and Toxicological Predictors of Intensive Care Unit Admission in Acute Poisoning: A Narrative Review of Recent Evidence (2024–2025)

• Neila MAAROUFI

• sirine neji

• ihsen abdeslem

Background: Acute poisoning is a major cause of morbidity, mortality, and intensive care unit (ICU) utilization worldwide. Accurate risk stratification is essential for guiding triage and optimizing outcomes.

Methods: Narrative review of literature (2024–2025) on clinical and toxicological predictors of ICU admission. Databases searched included PubMed, Embase, and Scopus using keywords: “acute poisoning,” “ICU admission,” “predictors,” and “toxins.” Studies reporting adult or pediatric cohorts were included.

Results: Key clinical predictors include decreased consciousness (GCS ≤8), hemodynamic instability, respiratory failure, severe metabolic acidosis (pH <7.25), elevated lactate, and electrolyte disturbances. High-risk toxins—organophosphorus pesticides, paraquat, cardiotoxic drugs, and psychotropic agents—are strongly associated with critical illness. Validated scoring systems, especially the new-Poisoning Mortality Score (new-PMS), outperform classical tools. Emerging biomarkers such as urinary 8-oxoGuo show promising prognostic value.

Conclusions: Multimodal approaches integrating clinical assessment, toxin-specific risk factors, validated scoring systems, and emerging biomarkers optimize ICU triage in acute poisoning. External validation and integration into emergency workflows are needed.

1. sirine neji

   residente en medecine d'urgence

2. ihsen abdeslem

   resident en medecine d'urgence

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