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
Abstract :
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.
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.
