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. 2009 Dec;24(4):362-7.
doi: 10.3904/kjim.2009.24.4.362. Epub 2009 Nov 27.

Factors for determining survival in acute organophosphate poisoning

Eun-Jung Kang  1 , Su-Jin Seok, Kwon-Hyun Lee, Hyo-Wook Gil, Jong-Oh Yang, Eun-Young Lee, Sae-Yong Hong
Affiliations

Factors for determining survival in acute organophosphate poisoning

Eun-Jung Kang et al. Korean J Intern Med. 2009 Dec.

Abstract

Background/aims: Organophosphate poisoning has a high mortality rate. Recently, differences among organophosphorus insecticides in human self-poisoning were reported. This study investigated the prognostic risk factors and the mortality of different organophosphates following acute organophosphate poisoning.

Methods: This retrospective study included 68 patients with acute organophosphate poisoning. We investigated patient survival according to initial parameters, including the initial Acute Physiology and Chronic Health Evaluation (APACHE) II score, serum cholinesterase level, and hemoperfusion and evaluated the mortality according to organophosphate types.

Results: Thirteen of the 68 patients died. The agents responsible for mortality were different. The APACHE II score was a significant predictor of mortality (odds ratio [OR], 1.194; p<0.01; 95% confidence interval [CI], 1.089 to 1.309) and respiratory failure (OR, 1.273; p<0.01; 95% CI, 1.122 to 1.444). The mortality was 0% for dichlorvos, malathion, chlorpyrifos and profenofos. However, other organophosphates showed different mortality (16.7% for O-ethyl-O-4-nitrophenyl phenylphosphonothioate, 25% for phenthoate, 37.5% for phosphamidon, 50% for methidathion). The usefulness of hemoperfusion appears to be limited.

Conclusions: The initial APACHE II score is a useful prognostic indicator, and different organophosphates have different mortality.

Keywords: APACHE; Organophosphate; Survival.

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Figures

Figure 1
Figure 1
The comparison of clinical outcome in patients with or without hemoperfusion treatment. The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher in patients with hemoperfusion treatment, but hemoperfusion treatment did not affect mortality.
Figure 2
Figure 2
The association between serum cholinesterase and the Acute Physiology and Chronic Health Evaluation (APACHE) II. A negative correlation between the APACHE II score and serum cholinesterase level was significant.
See this image and copyright information in PMC

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