1887
Volume 2023, Issue 1
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Organophosphate (OP) poisoning is a serious public health problem in underdeveloped nations. Many cases of severe poisoning and more than 220,000 deaths are recorded every year. Early detection and treatment can save lives because OP poisoning has a significant fatality rate. The new Poisoning Mortality Score (PMS) has been developed for clinical decision-making and therapeutic guidance in patients with acute poisoning.

This is a retrospective study that included 236 patients with acute OP poisoning who got admitted to a tertiary care hospital over two years after obtaining permission from the institutional ethical committee. The PMS, Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were calculated based on patient details.

The results showed that the mean age of patients was 32.8 ± 13.4 years; 50.8% were men and 49.2% were women. Out of 236 patients, 214 got discharged and 22 died. The mean ± SD of PMS, SOFA score, and APACHE II scores among the discharged patients were 51±7, 1 ± 2, and 5 ± 5, respectively, and those among the expired patients were 70 ± 12, 7 ± 3, and 28 ± 9, respectively. The best cut-off points for predicting mortality in acute OP poisoning patients for PMS, SOFA score, and APACHE II scores were >65, >3, and >15 with sensitivities of 77.27%, 95.45%, and 95.45%, specificities of 96.26%, 91.59%, and 95.79%, and areas under the receiver operating characteristic curve of 0.917, 0.970, and 0.984, respectively.

The study showed that the new PMS is significantly associated with the prediction of mortality in acute OP poisoning in comparison with SOFA and APACHE II scores.

Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2023.9
2023-02-06
2024-04-21
Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2023/1/jemtac.2023.9.html?itemId=/content/journals/10.5339/jemtac.2023.9&mimeType=html&fmt=ahah

References

  1. Hung D-Z, Yang H-J, Li Y-F, Lin C-L, Chang S, Sung F-C, et al. The long-term effects of organophosphates poisoning as a risk factor of CVDs: A nationwide population-based cohort study. BMJ. 2015; 10::137–40.
    [Google Scholar]
  2. Eddleston M, Phillips MR. Self poisoning with pesticides. BMJ. 2004; 328::42–4.
    [Google Scholar]
  3. Lee S, Barron M. Mechanism-based analysis of acetylcholinesterase inhibitory potency of organophosphates, carbamates, and their analogs. 17th International Conference on QSAR in Environmental and Health Sciences, Miami Beach, FL, June 13–17, 2016.
    [Google Scholar]
  4. Lotti M, Moretto A. Cholinergic symptoms and Gulf War syndrome. Nat Med. 1995; 1::1225–6.
    [Google Scholar]
  5. Singh G, Khurana D. Neurology of acute organophosphate poisoning. Neurol India. 2009; 57::119–25.
    [Google Scholar]
  6. Yanagisawa N, Morita H, Nakajima T. Sarin experiences in Japan: Acute toxicity and long-term effects. J Neurol Sci. 2006; 249::76–85.
    [Google Scholar]
  7. Silakhori S, Dadpour B, Khadem-Rezaiyan M, Sedaghat A, Mirzakhani F. Comparing APACHE II, APACHE IV, SAPS II, and SOFA predictive power in poisoned patients admitted to the intensive care unit. Int J Med Toxicol Forensic. 2020; 10:(2):28814.
    [Google Scholar]
  8. Han KS, Kim SJ, Lee EJ, Shin JH, Lee JS, Lee SW. Development and validation of new poisoning mortality score system for patients with acute poisoning at the emergency department. Crit Care 2021; 25:(1):29.
    [Google Scholar]
  9. Pietraszek-Grzywaczewska I, Bernas S, Łojko P, Piechota A, Piechota M. Predictive value of the APACHE II, SAPS II, SOFA and GCS scoring systems in patients with severe purulent bacterial meningitis. Anaesthesiol Intensive Ther. 2016; 48::175–9
    [Google Scholar]
  10. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996; 22:(7):707–10.
    [Google Scholar]
  11. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985; 13::818–29.
    [Google Scholar]
  12. Moon BH, Park SK, Jang DK, Jang KS, Kim JT, Han YM. Use of APACHE II and SAPS II to predict mortality for hemorrhagic and ischemic stroke patients. J Clin Neurosci. 2015; 22::111–5.
    [Google Scholar]
  13. Kim YH, Yeo JH, Kang MJ, Lee JH, Cho KW, Hwang S, et al. Performance assessment of the SOFA, APACHE II scoring system, and SAPS II in intensive care unit organophosphate poisoned patients. J Korean Med Sci. 2013 Dec; 28:(12):1822–6.
    [Google Scholar]
  14. Shama WS, El-Gharbawy DM, Wahdan AA, Hashem AA. Assessment of the efficacy of four scoring systems in prediction of acute organophosphorous poisoning outcome. Tanta Med J. 2021; 49::187–97.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/jemtac.2023.9
Loading
/content/journals/10.5339/jemtac.2023.9
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error