Early Markers in Severe Organophosphorus Poisoning and Their Association with Mortality

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-06-01 DOI:10.1016/j.jemermed.2024.12.004

Ashaq Hussain Parrey MD, FACR, Manzoor Koka MD, Mohd. Ismail MD, Mohd. Ashraf MD, Hyder Lone MD

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引用次数: 0

Abstract

Background

Organophosphorus (OP) poisoning, in addition to its cholinergic manifestations, shows metabolic derangements leading to acidosis, hypokalemia, hyperlactemia, and hyperglycemia. In addition to low acetylcholinesterase, these markers could serve as early predictors of severity of poisoning and mortality.

Objective

The objective of this study was to assess the metabolic parameters at presentation in OP poisoning and their association with mortality.

Methods

This was a prospective study that recruited 152 patients older than 14 years with a history of OP ingestion within 6 h of presentation.

Results

In this study, 11 (6 male and 5 female) of 152 patients died (mortality rate 7.2%).. Mean age of the patients who died was 47 years and mean age of those who survived was 29 years. Ten of 11 patients (90%) who died had fasciculations at presentation. Metabolic parameters that were abnormal at presentation with significant correlation with mortality were acidosis (pH < 7.35) in 8 of 11 patients who died (72.7%) compared with 27.7% in those who survived. Hyperlactemia with serum lactate > 2 mmol/L was seen in 10 of 11 patients (90.1%) who died during hospital stay compared with 39% of patients who survived. Hypokalemia with potassium < 3.5 mmol/L was seen in 8 of 11 patients who died (72.7%) compared with 34.7% of those who survived.

Conclusions

Hypokalemia, hyperlactemia, hyperglycemia, fasciculations, and advanced age are early markers predicting poor outcomes in OP poisoning.

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重度有机磷中毒的早期标志物及其与死亡率的关系

背景：有机磷（OP）中毒，除了其胆碱能表现外，还表现为代谢紊乱，导致酸中毒、低钾血症、高乳酸血症和高血糖。除了低乙酰胆碱酯酶外，这些标志物还可以作为中毒严重程度和死亡率的早期预测指标。目的：本研究的目的是评估OP中毒时的代谢参数及其与死亡率的关系。方法：这是一项前瞻性研究，招募了152例年龄大于14岁且就诊后6小时内有OP摄入史的患者。结果：本组152例患者死亡11例（男6例，女5例），死亡率7.2%。死亡患者平均年龄为47岁，存活患者平均年龄为29岁。死亡的11例患者中有10例（90%）在就诊时出现了抽搐。11例死亡患者中有8例（72.7%）出现与死亡率显著相关的代谢参数异常，酸中毒（pH < 7.35），而存活患者中这一比例为27.7%。住院期间死亡的11例患者中有10例（90.1%）出现高乳酸血症伴血清乳酸浓度2 mmol/L，而存活的患者中有39%出现高乳酸血症。11例死亡患者中有8例（72.7%）出现钾< 3.5 mmol/L的低钾血症，而存活患者中有34.7%。结论：低钾血症、高血、高血糖、抽搐和高龄是预测OP中毒不良结局的早期指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine