Department of Emergency medicine, Chonnam National University Hospital, Gwangju, South Korea.
Clin Toxicol (Phila). 2012 Nov;50(9):832-7. doi: 10.3109/15563650.2012.727093. Epub 2012 Sep 21.
Carbamate is a widely used insecticide, and fatality due to carbamate insecticide intoxication has been reported. However, no studies have addressed the factors associated with outcome of patients poisoned by carbamate insecticide. The present study sought to identify the independent factors that could help predict the development of medical complications as a result of carbamate intoxication.
Fifty two patients presenting with acute carbamate insecticide ingestion at Chonnam National University Hospital were enrolled in this retrospective observational case series. The morbidities that needed intensive treatment such as hypotension, respiratory failure, and death were regarded as complications. To identify the associated factors to these complications, objective variables that are easily assessed at presentation, such as age, initial Glasgow coma scale (GSC) and corrected QT (QTc) prolongation, were analyzed by univariate and multivariate stepwise logistic regression analyses.
Of the 52 patients, 35 (67.3%) had medical complications within 24 hours after carbamate insecticide intoxication and seven (13.5%) died. Respiratory failure was the most common medical complication. The significant factors determined by univariate analysis were initial GCS, elevated lactate, and QTc prolongation. However, initial GCS (≤13) was the only independent factor determined by multivariate analysis that was associated with serious complications requiring intensive medical treatment.
Carbamate insecticide intoxication is not a mild disease, as previously thought, having a mortality rate of 13.8% and a morbidity rate of 67.3%. Initial GCS ≤ 13 can be used as a significant factor to identify carbamate insecticide-intoxicated patients who will experience complications.
氨基甲酸酯类是一种广泛使用的杀虫剂，已有因氨基甲酸酯类杀虫剂中毒而死亡的报道。然而，目前还没有研究探讨与氨基甲酸酯类杀虫剂中毒患者结局相关的因素。本研究旨在确定有助于预测因氨基甲酸酯类中毒而发生医疗并发症的独立因素。
本回顾性观察性病例系列研究纳入了在全南国立大学医院就诊的 52 例急性氨基甲酸酯类杀虫剂摄入患者。需要强化治疗的并发症，如低血压、呼吸衰竭和死亡，被视为并发症。为了确定这些并发症的相关因素，通过单变量和多变量逐步逻辑回归分析，对入院时容易评估的客观变量（如年龄、初始格拉斯哥昏迷量表[GCS]和校正 QT [QTc]延长）进行分析。
在 52 例患者中，有 35 例（67.3%）在氨基甲酸酯类杀虫剂中毒后 24 小时内出现医疗并发症，有 7 例（13.5%）死亡。呼吸衰竭是最常见的医疗并发症。单变量分析确定的显著因素为初始 GCS、乳酸升高和 QTc 延长。然而，初始 GCS（≤13）是通过多变量分析确定的与需要强化医疗治疗的严重并发症相关的唯一独立因素。
氨基甲酸酯类杀虫剂中毒并非如之前认为的那样是一种轻度疾病，其死亡率为 13.8%，发病率为 67.3%。初始 GCS≤13 可作为一个显著因素，用于识别可能发生并发症的氨基甲酸酯类杀虫剂中毒患者。
