Morbidity and Mortality Indicators in Acute Organophosphate Poisoning in Zagazig University Hospital, Egypt: Retrospective Study

Abstract

Introduction: Organ phosphorus (OP) toxicity has been studied extensively because of its world wide use. Toxicity of organophosphates is the result of inhibition of acetyl cholinesterase resulting in cholinergic signs. Aim of the Work: To evaluate initial indicators that can indicate prognosis of patients in OP poisoning. Materials and Methods: A retrospective study conducted in Zagazig university hospital over a year. OP poisoning was clinically diagnosed with history of OP compound exposure and confirmed by low pseudo cholinesterase levels. Results: In the present study, 76 patients were enrolled. Major cases were male. High mortality rates were in the youth and in prolonged ventilated patients. The mortality rate was proportionally related to lag time after exposure and plasma pseudo cholinesterase levels. Electrolyte disturbance did not affect clinical outcome. Conclusion: From this study, it could be concluded that mortality is directly proportionate to the lag time, amount of OP consumed, clinical severity, pseudo cholinesterase levels and duration of ventilator support. This study helps in rapid diagnosis, and rapid early and effective treatment, which may result in decreasing the morbidity and mortality rates. Recommendation: It is recommended to increase awareness regarding the rapid diagnosis, and rapid effective treatment of organ phosphorous.

Trajectories of vital status parameters and risk of mortality among acute organophosphorus poisoning patients – a latent class growth analysis

“…However, in our cohort, the patients all has been directly transferred from emergency to intensive care units, which reflects predominantly more severe forms of poisoning cases with deteriorating clinical condition and explains the high mortality in our study compared to the previous study. Older age and longer time elapsed since ingestion of poison were significant predictors of mortality in our series, and the findings are quite consistent with previously published studies [ 18 , 27 , 42 ].…”

“…These findings suggest that routine clinical parameters, if observed repeatedly, might be useful clinical tools to identify high-risk groups of patients who might experience considerably high mortality. The mortality in our study is comparable to previously published papers on OP poisoning from different regions, including neighbouring countries [ 4 , 9 , 18 , 27 , 40 – 42 ]; however, our study appeared to show higher (13.4%) mortality compared to a published paper (4.11%) [ 42 ] from another tertiary care setting in our metropolitan city. Although the average ages of patients in their study and our study were comparable, a significantly higher percentage of women (73%) was enrolled in the previously published study [ 42 ] than in our study (52.5%).…”

“…One-third of all OP poisoning patients also require mechanical ventilation (MV) due to heavy ingestion, the toxicity of the poison ingested and delayed presentation at the hospital [17][18][19], and among OP poisoning patients on MV, low pseudocholinesterase (PChE), high creatinine (Cr), low Glasgow Coma Scale (GCS) score and long hospitalization durations are all linked with high mortality [10][11][12]17].…”

Latent Class Trajectories of Biochemical Parameters and Their Relationship With Risk of Mortality Among Acute Organophosphorus Poisoning Patients

“…Low mortality in the previous study was perhaps because the study had only six months records available (46.1% (1174/2546)) for those OP poisoning patients who were managed in medical wards [6] whereas our study spanned over six years patients data recorded from OP poisoning patients admitted in ICU. Longer time elapsed since ingestion of poison and higher age was signi cant predictors of mortality and ndings are quite consistent with previously published studies [13,26,36].…”

“…The mortality in our study is comparable to previously published papers on OP poisoning from different regions including neighbor countries [5,6,13,26,[36][37][38], however our study appeared to show higher (13.7%) mortality compared to another recently published paper (2.7%) from National Poisoning Control Centre of our urban city. Low mortality in the previous study was perhaps because the study had only six months records available (46.1% (1174/2546)) for those OP poisoning patients who were managed in medical wards [6] whereas our study spanned over six years patients data recorded from OP poisoning patients admitted in ICU.…”