Background: Monitoring a patient's serum acetylcholinesterase (AChE) status after clinical score of organophosphate poisoning enables the verification of exposure to anticholinesterase agents. Methods: A cross-sectional study was conducted among the patients fulfilling the inclusion criteria and was categorized according to POP (Peradeniya Organophosphorus Poisoning) score. The study was conducted at a tertiary hospital for one year in the period of Jan 2016 to Dec 2016. POP score was applied and serum acetylcholinesterase level was determined in the lab. Spearman’s rho coefficient method was applied for correlation. Results: Seventy four patients survived in emergency ward who presented within (4.1 ± 2.9; 95% confidence interval [CI], 3.43- 4.80; P= 0.021) hours of ingestion of OP compounds, POP score 3 (Q1, Q3, 2, 4), serum AChE 2221 (Q1, Q3, 768.5, 4703.5) IU/L with 9 ( Q1,Q3, 8.75, 34.75) mg of atropine used, 94% received PAM for 5 (Q1, Q3, 3, 7) days of hospital stay. Four patients died within (7.5 ± 5.4; 95% CI, -1.16- 16.16; P= 0.021) hours of presentation, POP score of 4 (Q1, Q3, 4, 7.75), serum AChE 588 (Q1, Q3, 173, 1912) IU/L, atropine used 170 (Q1, Q3, 152.5, 297) mg, 5.1% received PAM for 3.5 (Q1, Q3, 1, 11.25) days of hospital stay. Spearman’s rho coefficient showed well correlation between POP score and serum AChE level (coefficient -0.356; P= 0.001), POP score for the need of atropine (coefficient= 0.536; P= 0.001). Serum AChE also correlated with the length of hospital stay (coefficient= 0.414; P= 0.001) compared to POP score (coefficient= 0.420; P= 0.001). Conclusions: The higher degree of POP score correlated to higher degree of serum acetylcholinesterase derangement, need for atropine, PAM and length of hospital stay. Thus, it enhances in the prediction of outcome among patients with acute organophosphate poisoning at index visit.
Background: The emergency department (E. D.) of any hospital is an important entry point of critically ill patients. The initial management of these patients is often challenging, and for valuable lives to be saved, the infrastructure and manpower should be up-to-date. Materials and Methods: This retrospective study was carried out from previous medical record of emergency ward of B. P. Koirala Institute of Health Sciences (BPKIHS) from April 2015 to March2016. Total duration of study was one year. Data was extracted from medical records, entered in Mescal and analyzed with SPSS software. Results: The mortality rate at the BPKIHS emergency ward was 1.05%. Their ages ranged from 10-91 years with 43% of deaths among age >60 years. There was a similar proportion of death among the males and females, with almost 90% of cases in the Australian Triage Score (ATS) 1 and 2, i.e. the most severe cases. Sepsis, chronic obstructive pulmonary disease and chronic kidney disease were the common causes of death in BPKIHS emergency ward. Conclusion: Mortality was high in ATS 1 and 2, i.e. severe cases of ED. There is a need for further exploration of the cases including the morbidity profiles at BPKIHS emergency ward. More studies are needed to come to a conclusion regarding the quality of care.
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