To identify morbidity and mortality predictors in acute organophosphate poisoning

BACKGROUND: Organophosphorus poisoning remains an important cause of morbidity and mortality, but no definite parameters have been identified as predictors of outcome. Prediction of morbidity at presentation might help in decision making in places of limited resources like rural settings in developing countries. MATERIALS AND METHODS: A total of 76 cases were included in this retrospective cohort study. Logged relative risk of requirement of mechanical ventilation and hospital stay >7 days was measured in patients with serum acetylcholinesterase (s. acetylcholinesterase) <1000 versus >1000, presenting in <2 h versus ≥ 2 h after exposure, with Glasgow Coma Scale (GCS) ≤12 versus >12 and in patients with SpO(2) <85% versus ≥85% at room air at presentation. RESULTS: S. acetylcholinesterase <1000, time elapsed after ingestion to presentation ≥ 2 h and SpO(2) (at room air) at presentation <85% were found to have positive association with requirement of ventilation. GCS ≤ 12 had a significant association with both requirement of ventilation and hospital stay >7 days. CONCLUSION: S. acetylcholinesterase, SpO(2) at room air, GCS, and duration of exposure at presentation can be used to identify the requirement of special care in acute organophosphorus poisoning. This can aid in decision making regarding admission to intensive care unit and referral in the places with limited resources.