Korean J Intern Med.  2009 Dec;24(4):362-367. 10.3904/kjim.2009.24.4.362.

Factors for Determining Survival in Acute Organophosphate Poisoning

Affiliations
  • 1Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. hwgil@schca.ac.kr

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.

Keyword

Organophosphate; Survival; APACHE

MeSH Terms

APACHE
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Cholinesterases/blood
Female
Humans
Male
Middle Aged
Organophosphorus Compounds/*poisoning
Poisoning/mortality
Prognosis
Retrospective Studies
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