Predictors of Morbidities in Organophosphate Poisoning


Authors : Dr. Digbijay Kumar Thakur; Dr. Rameshwar Mahaseth; Dr. SidhiDatri Jha

Volume/Issue : Volume 7 - 2022, Issue 3 - March

Google Scholar : https://bit.ly/3IIfn9N

Scribd : https://bit.ly/3r8IPj0

DOI : https://doi.org/10.5281/zenodo.6421676

Organophosphate compounds are the most common pesticides with high potential for producing acute and sub-acute toxicities. As we know, debates continue over indicators of poor prognosis and mortality.we intended to observe if morbidity in terms of requirement of ventilation, complications developed, prolongation of QTc interval, derangement in liver and renal functions, hospital stay and need of ICU admission can be assessed from clinical parameters at presentation.This might enable clinicians to identify patients needing intensive monitoring and treatment. Methods: This is a cross sectional observational hospitalbasedstudy.Patients were grouped into age class intervals, severity of poisoning done on the basis of ACHE level and POP score. QTc was calculated by Bazzetˈs formula, grouped into normal and prolonged categories. Statistical analysis was done by SPSS 25. Observations and results: Altogether 66 patients were enrolled in this study. Among them, 22(33.33%) were male and 44(66.7%) were female. Patients with deranged LFT and RFT were found to have higher mean amount of organophosphate compound ingested, p < 0.05. Both deranged LFT and RFT group were having higher mean value for dose of atropine to reach atropinization, WBC count, QTc level and lower mean value for O2 saturation; p < 0.05. Those admitted in ICU and having infiltrates on chest x-ray were having higher mean amount of op compound ingested, were requiring higher atropine to reach atropinization, having higher pop score, found to have tachypnoea, higher mean QTc interval, lower mean SBP and lower mean O2 saturation; p < 0.05. Patients with long hospital stays and developing complications specially those requiring vasopressor and ventilatory support were having higher mean amount of op compound ingested, large mean dose of atropine to reach atropinization, prolonged mean QTc interval, high mean respiratory rate, higher WBC count, higher mean pop score, lower SBP and lower mean O2 saturation. Similarly, patients with lower GCS score were having higher mean value for amount of op compound ingested (p = 0.018), pop score (p = 0), RR (p = 0) and lower mean value for O2. similarly, patients with severe poisoning were requiring higher dose of atropine to reach atropinization, developing complications and needing ICU admission, requiring long hospital stays, needing vasopressor support, having prolonged QTc interval and low GCS core; p < 0.05. Conclusion: Amount of organophosphate compound ingested, higher dose of atropine to achieve atropinization, low GCS, high respiratory rate, low oxygen saturation, prolongation of QTc interval, high WBC count, low systolic BP, low serum ACHE level and high pop scores are predictors of morbidities in acute organophosphate poisoning

Keywords : Organophosphate compound, atropine, atropinization, pop score, Ache level.

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