Prognostic factors and predictive models for outcomes in organophosphate poisoning: A retrospective analysis

Abstract

Purpose

This study aimed to identify prognostic factors and develop a predictive model for patients with organophosphate poisoning.

Methods

A retrospective analysis of 108 cases was conducted, collecting demographic, clinical, and laboratory data including age, sex, time to treatment, plasma organophosphate (OP) levels, arterial lactate (LAC), aspartate aminotransferase (AST), creatinine (Cr), and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. Patients were categorized into survivor and non-survivor groups. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed to identify independent prognostic factors and assess their predictive value.

Results

The overall mortality rate was 23.15%. Non-survivors had higher age, LAC, AST, Cr, and APACHE II scores, and lower AChE levels compared to survivors. Multivariate logistic regression identified age (OR: 1.12, 95% CI: 1.05–1.22) and AST (OR: 1.03, 95% CI: 1.01–1.05) as independent prognostic factors. ROC analysis validated a model combining age, AChE, and AST, showing an excellent discriminative ability with an AUC of 0.95 (95% CI: 0.91–0.99), sensitivity of 1.00, and specificity of 0.90.

Conclusions

Age and AST are significant prognostic factors for organophosphate poisoning. Combining these factors enhances predictive accuracy, aiding clinical decision-making and emphasizing early aggressive management to improve survival rates.