Scoring Methods for Prognosis of Patients with Acute Severe Organophosphate Intoxication

Ha, Tae Wook; Han, Yong Jae; Yoo, Su Jin

Abstract

PURPOSE: Although, there have been many reports about factors involved in the severity and prognosis of organophosphate toxicity, there are few reports on integrated application of scoring methods using those factors for prognosis. Our report is about the possible application of such scoring methods in the early stage of organophosphate intoxication.
METHODS
This study included organophosphate intoxication patients who were admitted to the Emergency department (ED) between March 1, 2004 and February 28, 2008. We limited enrolment in the study to patients who had required assisted mechanical ventilation and used atropine for therapy. This was a retrospective study about age, drug toxicity, mental status, existence of metabolic acidosis and QT prolongation for each patient.
RESULTS
Thirty seven patients were enrolled in this study. Among the 37, 22 survived and 15 died. For survivors, drug toxicity and mental status were correlated with total dose of atropine, and the existence of metabolic acidosis was correlated with the duration of mechanical ventilation. Survivors had lower total scores than non-survivors.
CONCLUSION
Application of scoring methods that include five factors (age, drug toxicity, mental status, existence of metabolic acidosis, existence of QTc prolongation) when acute, severe, organophosphate poisoning patients arrive at an ED can be helpful for their prognosis.