Abstract | UNLABELLED: METHODS: This retrospective study spanned 6 years (2002-2007). Patients were treated with atropine and supportive care including ventilation, as required, and followed up until death or hospital discharge. Oximes were not administered. Of the 422 charts retrieved, 396 fulfilled inclusion criteria. Data on the clinical profile, ventilation, length of hospital stay, incidence of intermediate syndrome and mortality were extracted. RESULTS: The mean (± standard deviation) age was 31.4 ± 12.7 years with a male preponderance (2.6:1). The median (interquartile range (IQR)) admission pseudocholinesterase level of 317 (222-635) U/L indicated significant inhibition of cholinesterase activity. The median lag-time to presentation to our hospital was 5 (IQR 3-8.5) hours. Oximes were administered at a primary center in 33 patients (8.3%). Dimethyl organophosphate was ingested by 141 patients, diethyl organophosphate by 108, S-alkyl organophosphate by 2, and an un-identified organophosphate by 145 patients. Ventilation was required in 260 patients (65.7%); the median duration of ventilation being 7.5 (IQR 3-12) days. Overall mortality was 13.1%. There was a significant difference between dimethyl and diethyl organophosphate compounds in ventilatory requirement (76% vs. 56%, adjusted odds ratio (OR) 2.37, 95% CI 1.01-5.57, p=0.047), duration of ventilation (11 (4-15) vs. 5 (2-9) days, adjusted OR 1.12, 95%CI 1.04-1.21, p=0.002) and incidence of intermediate syndrome (72/125 (58%) vs. 24/92 (26%), adjusted OR 2.84, 95%CI 1.38-5.86, p=0.004). Mortality was similar in the two groups (20/141 (14%) vs. 7/108 (6%), dimethyl vs. diethyl organophosphate, adjusted OR 1.29, 95%CI 0.43-3.94, p=0.65). CONCLUSIONS:
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Authors | John Victor Peter, Jayakumar Jerobin, Anupama Nair, Anjana Bennett, Prasanna Samuel, Anugrah Chrispal, Ooriapadickal Cherian Abraham, Kuruvilla Prasad Mathews, Jude Joseph Fleming, Anna Oommen |
Journal | Clinical toxicology (Philadelphia, Pa.)
(Clin Toxicol (Phila))
Vol. 48
Issue 9
Pg. 916-23
(Nov 2010)
ISSN: 1556-9519 [Electronic] England |
PMID | 21171848
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Atropine
(therapeutic use)
- Female
- Hospital Mortality
- Hospitalization
- Humans
- Male
- Middle Aged
- Organophosphate Poisoning
- Respiration, Artificial
- Retrospective Studies
- Young Adult
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