J Korean Soc Clin Toxicol.  2017 Jun;15(1):11-16. 10.22537/jksct.2017.15.1.11.

Hypoalbuminemia as a Predictor of 30-day Mortality in Patients with Acute Organophosphate Insecticide Poisoning

• Kim SY
• Lee RK
• Kim TH
• Kim DH
• Kim T
• Lee SH
• Jeong JH
• Lee SB
• Kang C

• KMID: 2386860
• DOI: http://doi.org/10.22537/jksct.2017.15.1.11

Abstract

PURPOSE
The association of hypoalbuminemia with 30-day in-hospital mortality in patients with organophosphate insecticide poisoning (OPI) was studied.
METHODS
This retrospective cohort study was conducted between January 2006 and November 2013 in the emergency department (ED) after OPI poisoning. A Kaplan-Meier 30-day survival curve and the log-rank test were used to analyze patients stratified according to serum albumin levels on ED admission (hypoalbuminemia or normo-albuminemia). Independent risk factors including hypoalbuminemia for 30-day mortality were determined by multivariate Cox regression analysis.
RESULTS
A total of 135 patients were included. Eighty-eight (65%) patients were male and the mean age was 57.3±17.0 years. Serum albumin, mean arterial pressure, and Glasgow coma scale score were significantly higher in the survival group than the non-survival group. APACHE II score was significantly lower in the non-survival group than the survival group. The mortality of the hypoalbuminemia group (serum albumin <3.5 g/dl) was 68.8%, while that of the normo-albuminemia group (serum albumin ≥3.5 g/dl) was 15.1%. The area under the ROC curve of the serum albumin level was 0.786 (95% CI, 0.690-0.881) and the APACHE II score was 0.840 (95% CI, 0.770-0.910).
CONCLUSION
Hypoalbuminemia is associated with 30-day mortality in patients with OPI poisoning.

Keyword

Organophosphate; Insecticide; Poisoning; Hypoalbuminemia; Mortality

MeSH Terms

APACHE
Arterial Pressure
Cohort Studies
Emergency Service, Hospital
Glasgow Coma Scale
Hospital Mortality
Humans
Hypoalbuminemia*
Male
Mortality*
Poisoning*
Retrospective Studies
Risk Factors
ROC Curve
Serum Albumin
Serum Albumin