Prognostic factors determining morbidity and mortalityin organophosphate poisoning

Ayça Açıkalın, Nezihat Rana Dişel, Selçuk Matyar, Ahmet Sebe, Zeynep Kekeç, Yüksel Gökel, Emre Karakoç

Abstract


Objective: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate (OP) poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature.

Methods: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department (ED) or intensive care unit (ICU) of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated. All the data were obtained from electronic and manual patient files. A total of 80 patients were included in the study.

Results: The mean age of the study patients was 32.4±15.0 (13-94). Forty-nine (61.2%) patients were female. Twenty-two (27.5%) patients were seriously poisoned and needed mechanical ventilation (MV) support. Low pseudocholinesterase (PChE), high creatinine (Cr), low Glasgow Coma Scale (GCS) scores and long hospitalization durations were all found to be poor prognostics in MV patients. Low PChE and high Cr levels were found to be independent predictors of the hospitalization duration and high Cr was found to be an independent predictor of the intubation duration of MV patients in regression analyses. Ten (45.5%) of the MV patients were unresponsive to medical treatment and Therapeutic plasma exchange (TPE) was performed. Seven patients were discharged healthy. Three patients with low PChE levels and comorbidities died.

Conclusions: Prolongation of respiratory depression necessitating MV support, comorbidities, long hospital stay, elevated creatinine, low GCS scores and low PcHE levels without regeneration in the first 48 hours of admission are all found to be poor prognostic factors  for organophosphate (OP) poisoning.

doi: https://doi.org/10.12669/pjms.333.12395

How to cite this:Acikalin A, Dişel NR, Matyar S, Sebe A, Kekec Z, Gokel Y, et al. Prognostic factors determining morbidity and mortality in organophosphate poisoning. Pak J Med Sci. 2017;33(3):534-539.   doi: https://doi.org/10.12669/pjms.333.12395

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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