Early Discharge of Patients with Presumed Opioid Overdose: Development of a Clinical Prediction Rule

• DOI: 10.1111/j.1553-2712.2000.tb01260.x
• Publication Date: 2008-01-08T15:11:12Z
• Authors: Jim Christenson; Jeremy Etherington; Eric Grafstein; Grant Innes; Sarah Pennington; Karen Wanger; Chris Fernandes; John J. Spinelli; Min Gao
• Keywords: Clinical prediction rule; Opioid Overdose; Respiratory Rate; Coma (optics); Vital signs

Abstract. Objective: To develop a clinical prediction rule to identify patients who can be safely discharged one hour after the administration of naloxone for presumed opioid overdose. Methods: Patients received known or overdose were formally evaluated later multiple potential predictor variables. classified into two groups: those with adverse events within 24 hours and without. Using classification regression tree methodology, decision was developed predict safe discharge. Results: Clinical findings from 573 allowed us sensitivity 99% (95% CI = 96% 100%) specificity 40% 36% 45%). if they: 1) mobilize as usual; 2) have oxygen saturation on room air >92%; 3) respiratory rate >10 breaths/min <20 breaths/min; 4) temperature >35.0°C <37.5°C; 5) heart >50 beats/min <100 beats/min; 6) Glasgow Coma Scale score 15. Conclusions: This early discharge performs well in this derivation set but requires validation followed by confirmation implementation.