The clinico-demographic study of morbidity and mortality in patients with organophosphate compound poisoning at tertiary care hospital in rural India

Abstract

Background: Organophosphates (OP) are commonly used and potentially fatal insecticides. Given the unrestricted availability and widespread use, OP poisoning is very much common following either accidental or intentional exposures. Many parameters are proposed to predict outcome, yet there is no consensus about these parameters. This study aimed to investigate different factors associate with morbidity and mortality in rural population that can help in identifying patients in need of intensive care and treatment to prevent deaths.Methods: This was a cross-sectional observational study of 323 patients, admitted to the tertiary care rural public hospital with OP poisoning between December 2015 to November 2016.Results: Of the 323 patients studied, 62.85% were male, 227 (70.27%) were suicides, 241 (74.61%) ingested OP compounds, 40 (12.38%) patients developed intermediate syndrome and 56 (17.34%) died. There were statistically significant differences between ventilatory support group and no ventilatory group for suicidal intention, sex, comorbid psychiatric conditions, route of exposure, certain clinical features on admission, GCS score, POP scale, time from exposure to initiation of treatment, plasma pseudocholinesterase levels, oxygen saturation, and random blood sugar levels (p<0.05).Conclusions: OP poisoning is a life-threatening condition which requires immediate management. Early initiation of decontamination, atropine and pralidoxime therapy, with supportive ICU care, can save lives. Different demographic, exposure related parameters; some of the clinical features, treatment variables and certain laboratory findings can provide useful prognostic information and help to predict outcomes. A measures to control unchecked availability of these compounds and early transfer of victims to health care facility is needed to save many lives.

Comparative Study of Glasgow Coma Score, Poisoning Severity Score and APACHE 2 Score in Predicting Outcome of the Patients with Organophosphate Poisoning

“…Of the 100 patients included in the study, 70% were male and 30% were female. This finding correlated well with the studies done by Mundhe et al [6] and Rajeev and Arvind, [7] where there was a male predominance too (62.85% and 66%, respectively). Males have more access to OP compounds than their counterparts.…”

“…Majority of the patients belonged to the age group of 21-30 years (33%) followed by 31-40 years (22%). The studies by Mundhe et al [6] and Rajeev and Arvind [7] reflected the same. This age group is the most productive age group of the society prone to accidental exposures.…”

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

“…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.…”

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

“…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%).…”