Mortality in patients presenting with organophosphorus poisoning at Liaquat University of Medical and Health Sciences
Abstract
Objective: Organophosphorus (OP) poisoning leads to high morbidity and mortality. The objective of this study was to evaluate the mortality due to Organophosphorus poisoning.
Methodology: This descriptive and analytical study was conducted at a Medical Unit-1 and Intensive Care Unit of Liaquat University Hospital (LUH) Hyderabad/Jamshoro from October 2009 to Feb 2011. All patients with suspicion of OP poisoning were admitted. Their history and clinical features were recorded. The diagnostic criteria of the study were history from parents about ingestion of organophosphorus poison and clinical signs like excessive bradycardia, salivation, meiosis and wheezing. The exclusion criteria were absence of meiosis and patients who expired in emergency department before reaching in intensive care unit or medical wards. The data was analyzed with SPSS version 11.
Results: During the period of study 100 patients were studied with the diagnosis of OP poisoning divided into grades according to severity. Their age ranged 18-58 years with mean age of 37.5±9.5 years and median age was 43 years. Males were 78 (78%) and females were 22 (22%) with M/F ratio of 7.8/2.2. 20 (20%) patients were of mild severity, 40 (40%) were of moderate severity, and 40 (40%) were of severe grade. The most common route of OP exposure was ingestion 79 (79%), followed by inhalation and dermal absorption 21 (21%). The clinical features as hyper salivation, meiosis, wheezing and depressed mental status were present in all (100%) of the patients followed by lacrimation 90 (90%), bradycardia 58 (58%), hypotension 76 (76%), chest crepitations 80 (80%), vomiting 69 (69%), abdominal cramps 40 (80%). Respiratory failure was seen in 42 (42%), sepsis in 5 (5%), seizures in 9 (9%), Pulmonary edema in 19 (19%) and ARDS in 10 (10%) patients. Forty (40%) patients were given mechanical ventilation with inotropic support. Average duration of hospital stay was 4.5 days ±SD 2.5 (range 3-22) days. Out of 100 patients 82 (82%) survived and the mortality was 18 (18%). Cause of death was mainly due to respiratory failure.
Conclusion: Mortality due to Organophosphate poisoning is extremely high in our part of the world. Recognition of clinical features will make easy and early diagnosis.
Methodology: This descriptive and analytical study was conducted at a Medical Unit-1 and Intensive Care Unit of Liaquat University Hospital (LUH) Hyderabad/Jamshoro from October 2009 to Feb 2011. All patients with suspicion of OP poisoning were admitted. Their history and clinical features were recorded. The diagnostic criteria of the study were history from parents about ingestion of organophosphorus poison and clinical signs like excessive bradycardia, salivation, meiosis and wheezing. The exclusion criteria were absence of meiosis and patients who expired in emergency department before reaching in intensive care unit or medical wards. The data was analyzed with SPSS version 11.
Results: During the period of study 100 patients were studied with the diagnosis of OP poisoning divided into grades according to severity. Their age ranged 18-58 years with mean age of 37.5±9.5 years and median age was 43 years. Males were 78 (78%) and females were 22 (22%) with M/F ratio of 7.8/2.2. 20 (20%) patients were of mild severity, 40 (40%) were of moderate severity, and 40 (40%) were of severe grade. The most common route of OP exposure was ingestion 79 (79%), followed by inhalation and dermal absorption 21 (21%). The clinical features as hyper salivation, meiosis, wheezing and depressed mental status were present in all (100%) of the patients followed by lacrimation 90 (90%), bradycardia 58 (58%), hypotension 76 (76%), chest crepitations 80 (80%), vomiting 69 (69%), abdominal cramps 40 (80%). Respiratory failure was seen in 42 (42%), sepsis in 5 (5%), seizures in 9 (9%), Pulmonary edema in 19 (19%) and ARDS in 10 (10%) patients. Forty (40%) patients were given mechanical ventilation with inotropic support. Average duration of hospital stay was 4.5 days ±SD 2.5 (range 3-22) days. Out of 100 patients 82 (82%) survived and the mortality was 18 (18%). Cause of death was mainly due to respiratory failure.
Conclusion: Mortality due to Organophosphate poisoning is extremely high in our part of the world. Recognition of clinical features will make easy and early diagnosis.
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