Yonsei Med J.  2018 Oct;59(8):982-988. 10.3349/ymj.2018.59.8.982.

Relative Risk and Clinical Severity Assessment in Patients with Non-Oral Route Organophosphate Poisoning Compared with Oral Route Poisoning

Affiliations
  • 1Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. erdoc74@gmail.com
  • 2Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 3Department of Medical Education, Yonsei University Wonju College of Medicine, Wonju, Korea.

Abstract

PURPOSE
Organophosphates, commonly used in agricultural pesticides, pose high risks and incidences of poisoning. In the present study, we investigated the relative risk and clinical severity, including laboratory results, of non-oral route poisoning (NORP) patients, compared to oral route poisoning (ORP) patients.
MATERIALS AND METHODS
A single institutional toxicology database registry was utilized to gain information on clinical laboratory results on organophosphate poisoning patients who visited the emergency department (ED) between January 2000 and October 2016. Clinical outcomes, such as mortality and complication rates, were compared using 1:2 propensity score matching in the total cohort.
RESULTS
Among a total of 273 patients in our study, 34 experienced NORP. After 1:2 propensity score matching, rates of respiratory complications and mortality were higher in the ORP group than in the NORP group. However, there was no difference in hospitalization time and time spent in the intensive care unit between the two groups. Compared with ORP patients after matching, the relative risk of mortality in NORP patients was 0.34, and the risk of respiratory distress was 0.47. The mean level of pseudocholinesterase was significantly higher in the NORP group than in the ORP group, while recovery rates were similar between the two groups.
CONCLUSION
Although the majority of NORP patients were admitted to the ED with unintentional poisoning and the relative risk of NORP was lower than that for ORP, we concluded that NORP is as critical as ORP. Considerable medical observation and intensive therapeutic approaches are also needed for NORP patients.

Keyword

Organophosphate; cholinesterase; propensity score

MeSH Terms

Cholinesterases
Cohort Studies
Emergency Service, Hospital
Hospitalization
Humans
Incidence
Intensive Care Units
Mortality
Organophosphate Poisoning*
Organophosphates
Pesticides
Poisoning*
Propensity Score
Pseudocholinesterase
Toxicology
Cholinesterases
Organophosphates
Pesticides
Pseudocholinesterase
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