Comparison of Severity in Organophosphate Insecticide Poisoning Patients Treated with Tracheostomy

Choo, Dae Hyuk; Park, Yong Jin; Kim, Sun Pyo; Kim, Seog Jung; Cho, Soo Hyung; Cho, Nam Soo

Abstract

PURPOSE
This study investigated the effect on survival rate for organophosphate intoxication patients who received tracheostomy. This research was conducted to help identify appropriate treatment of patients who received a trachostomy.
METHODS
This research was retrospectively conducted using the medical records of 141 patients who arrived at the Chosun University Hospital emergency medical center between Jan 2007 and Dec 2010, suffering from organophosphate intoxication. They were placed in two groups including one which received trachostomy as part of their treatment and one that did not. The effect of each variable on mortality was evaluated by regressionanalysis.
RESULTS
Of 141 patients with organophosphate intoxication, 105 of them did not tracheostomy and 16 were dead cohorts (15.2%). Their size of pupil was 1mm. Factors such as amount of organophosphate ingested, PAM time after ingestion, average body temperature, arrival time, atropinization time after ingestion, AST/ALT, Bun/Cr all appeared to be significant factors in death cohorts (P<0.05). 36 patients among the total had tracheostomy and 11 ones of them were in dead cohort (30.6%) and their average age was 58 years. The facts affect the state of patients in dead cohort include the amount of intoxication which between 327.27+/-194.1 ml, performing intubation 686 mins after intubation, reaching to the hospital after 580mins, injecting PAM 744 mins after intoxication, injecting atropine 627 mins after intoxication. The largest cases of patient's state was found to be stupor with 14 patients (38.9%) the level of Cholinesterase in blood appeared to be significant in dead cohort as 391.00+/-353.9 IU/L (P<0.05).
CONCLUSION
Further planned studies are necessary on the use of tracheostomy for treatment of poisoning victims, especially those intoxicated by organophosphorus insecticides.