Factors associated with outcomes in organophosphate and carbamate poisoning: a retrospective study

Reddy, Bobby; Skaria, Teny Grace; Polepalli, Sravani; Vidyasagar, Sudha; Rao, M. N. A.; Kunhikatta, Vijayanarayana; Nair, Sreekumaran; Thunga, Girish

doi:10.1007/s43188-019-00029-x

Cited by 23 publications

(16 citation statements)

References 39 publications

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“…In general, pediatric studies report frequency of unintentional ingestions and tend to have a lower mortality than adult studies. As reported by Reddy et al [20], and Ali et al [21] studies, adults are exposed to higher doses with intentional ingestions so carry higher mortality. The mean time to presentation from toxic exposure to hospital presentation in our study was significantly higher in non survivors.…”

Section: Discussionmentioning

confidence: 80%

Clinical profile and outcome of acute organophosphate poisoning in children of Upper Egypt: a cross-sectional study

2021

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Background Organophosphates are one of the most common agents of poisoning in developing countries including Egypt. Due to lack of data about characteristics of organophosphates poisoning in our localities, we aimed to evaluate its clinical pattern and factors affecting outcome. Methods It was a cross-sectional study conducted in South valley University hospital between January 2019 and December 2019. It included all children ≤16 years of age presented with organophosphates poisoning. Diagnosis was performed from the history taken from the patient’s relatives and presenting symptoms. Demographic data, mode and route of poisoning, time from exposure to presentation, clinical symptomatology, grading and routine investigations were evaluated in addition to treatment taken and outcome. Results During the study period, 108 children; mean age was 7.95 ± 4.11 years (range 1. 5-16 years) presented with organophosphorous poisoning. Sixty five (60%) cases were females and 43 (40%) were males. Unintentional acts (87%) were detected more than suicidal (13%) and inhalation route (63.8%) more than ingestion (36. 2%). Miosis was the most frequent clinical sign (100%) followed by respiratory distress (77.7%). Regarding time of presentation to emergency department, 43 (40%) cases were presented within 6 h while others presented more than 6 h post-exposure. Mechanical ventilation (MV) was needed for 14 (13%) cases and 6 (5.5%) cases died due to respiratory failure. Duration of hospital stay, mean time interval from toxic exposure to hospital presentation, leucocytosis, need for MV and cumulative dose of pralidoxime were significantly higher in non survivors than survivors while Pao2 (partial arterial oxygen) and GCS (Glasgow coma scale) were significantly lower. Conclusion This study concluded that time consumed till presentation to hospital, low GCS, need for MV, leucocytosis, decreased PaO2 and increased cumulative dose of pralidoxime were independent risk factors of mortality.

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Section: Discussionmentioning

confidence: 80%

Clinical profile and outcome of acute organophosphate poisoning in children of Upper Egypt: a cross-sectional study

2021

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“…(2020), who have conducted study in south India, reported 10.9% (66 out of 604) deaths among cases admitted due to poisoning. [ 29 ]…”

Section: Discussionmentioning

confidence: 99%

A hospital-based cross-sectional study on suicidal poisoning in Western Uttar Pradesh

Patel

Choudhary

et al. 2020

J Family Med Prim Care

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Background and Aims: Poisoning is most common method of committing suicide in India. Objectives of this study to assess prevalence of suicidal poisoning among all poisoning cases, its socio-demographic profile and its reasons in all admitted cases of suicidal poisoning in hospital. Methods: A cross-sectional study was conducted on cases of poisoning of any age group admitted in the Chhatrapati Shivaji Subharti Hospital, Meerut. Poisoning cases with history or evidence of suicide were further interviewed. A semi-structured interview schedule in Hindi was used to collect data. Microsoft Excel 365 and R software version 3.6.0 were used for data entry and analysis respectively. Results: Among total 135 poisoning cases admitted in hospital, 126 provided consent and included in the study. Prevalence of suicidal poisoning was 77.7% (98). Most common age group involved was 11-20 years (36.7%) and 21-30 years (35.7%) and most of the participants were males (59.2%). Most suicidal poisoning cases took Aluminum Phosphide (31.6%), followed by Organophosphates (20.4%) as poison. Most frequent reasons for suicide as described by participants were ’Family quarrel or family unhappiness’ (29.6%), ’failure in examination or interview or business’ (23.5%), ’ill treatment by spouse or in laws’ (16.3%) and ’unemployment’ (9.2%). Conclusion: Our study shows that consuming Agriculture poisons (Aluminum Phosphide and Organophosphates) are most common (52%) poisons consumed by suicidal poisoning cases. Agriculture poisons (Aluminum Phosphide and Organophosphates) are easily available in markets in India. There should be some restriction on their purchase to reduce suicidal incidences.

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“…Contradictory to the findings presented in this paper where men had comparatively more cure rate and women showed high probability of death, Reddy et al and Lee et al reported men as an independent variable contributing to increased mortality rate (odds ratio up to 2.5). 16,17 However, Munera Khan et al found no difference in gender-based outcome of poisoning. 18 Consumption of industrial poison in the present study was connected to highest mortality rate followed by agrochemical and household poisons in that order.…”

Section: Limitations Of Studymentioning

confidence: 99%

Probabilistic model to predict the outcome in acute suicidal chemical poisoning cases from age and gender of patient and type of chemical poison consumed

Bansal¹,

Jain²,

Agrawal³

et al. 2021

Scripta Medica

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Background: Acute chemical poisoning is a significant global health problem. Chemical poisons include agrochemical, household and industrial poison subtypes. The present study used a probabilistic model based on age, gender and type of poison consumed by the patient to predict the outcome in acute suicidal poisoning cases. Material and methods: A prospective observational study was conducted at emergency department of SMS Hospital, Jaipur, India, from January 2019 to February 2020. Patients over 15 years of age with poisoning severity score 2 or above were included in the study. Probabilistic model was used to predict the outcome measured in terms of cure, death and left against medical advice (LAMA) using Minitab 14. Results: Poisoning cases were 0.32 % of all emergency presentations. Out of them, 857 (59.6 %) had consumed chemical poison. Their mean age was 32 years and men to women ratio was 1.22. Agrochemical subtype was most common followed by household and industrial poisoning. Analysis by Probabilistic model showed that person between 30-60 years is more likely to be cured and chances of death and LAMA are highest in age group 60-75. Gender-wise, men have higher possibility for recovery. Besides, a person has highest chances of recovery in case of household poisons; death is most common in industrial poisons and LAMA in agrochemical poisons. Conclusion: The study concluded that in poisoning, patients' basic information like age, gender, type of poison consumed can be used to identify high death probability and LAMA risk patients. It will assist in designing and monitoring the most effective strategies for them.

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Factors associated with outcomes in organophosphate and carbamate poisoning: a retrospective study

Cited by 23 publications

References 39 publications

Clinical profile and outcome of acute organophosphate poisoning in children of Upper Egypt: a cross-sectional study

Clinical profile and outcome of acute organophosphate poisoning in children of Upper Egypt: a cross-sectional study

A hospital-based cross-sectional study on suicidal poisoning in Western Uttar Pradesh

Probabilistic model to predict the outcome in acute suicidal chemical poisoning cases from age and gender of patient and type of chemical poison consumed

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