The Features and Prognoses in Organophosphate Intoxication according to Age

Lim, Seung Wook; Park, Seung Min; Lee, Young Hwan; Lee, Won Woong; Ahn, Ji Yun; Sohn, You Dong; Ahn, Hee Cheol; Kim, Hyun

Abstract

BACKGROUND
The purpose of this study was to identify the factors that influence mortality in organophosphate intoxication and the differences between the elderly (> or =65 years) and younger adults (18-64 years) looking at vital sign, length of admission, cholinesterase activity, complications, and prognosis.
METHODS
All patients visiting one Emergency Department (ED) with organophophate intoxication between January 2000 and December 2011 were reviewed retrospectively. We divided the patients into two groups, geriatric adults (> or = 65 years) and nongeriatric adults (18-64 years).
RESULTS
During the study period, 155 patients (45 patients, > or =65 years; 110 patients, 18-64 years) presented to the ED with organophosphate intoxication. Thirty-six elderly patients (80.0%) vs. 63 younger adult patients (57.3%) were intubated endotracheally, with the analysis showing a clear distinction between the two groups (p=0.026). Twenty-two elderly patients (48.9%) vs. 23 younger adult patients (20.9%) went into shock, displaying a significant gap (p=0.008). Thirtyfive elderly patients (81.4%) vs. 62 younger adult patients (59.0%) developed respiratory complications and 20 elderly patients (46.5%) vs. 19 younger adult patients (18.1%) developed central nervous system complications, with obvious differences seen in each of the comparison at (p=0.031) and (p=0.005), respectively. Comparing plasma cholinesterase levels at 1st, 3rd, 5th, 10th, 15th, and 20th days, the rate of increase was faster in the younger adults (p=0.022).
CONCLUSION
With organophosphate intoxication, elderly patients tended to be intubated endotracheally, went into shock, developed central nervous system complications, were more severe, and showed a slower increase in cholinesterase level.