Jung Woo Jin, Yu Min Heui, Lee Yoonsuk, Kim Hyun, Cha Yong Sung, Park Kyung Hye
Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea.
Yonsei Med J. 2018 Oct;59(8):982-988. doi: 10.3349/ymj.2018.59.8.982.
Organophosphates, commonly used in agricultural pesticides, pose high risks and incidences of poisoning. In the present study, we investigated the relative risk and clinical severity, including laboratory results, of non-oral route poisoning (NORP) patients, compared to oral route poisoning (ORP) patients.
A single institutional toxicology database registry was utilized to gain information on clinical laboratory results on organophosphate poisoning patients who visited the emergency department (ED) between January 2000 and October 2016. Clinical outcomes, such as mortality and complication rates, were compared using 1:2 propensity score matching in the total cohort.
Among a total of 273 patients in our study, 34 experienced NORP. After 1:2 propensity score matching, rates of respiratory complications and mortality were higher in the ORP group than in the NORP group. However, there was no difference in hospitalization time and time spent in the intensive care unit between the two groups. Compared with ORP patients after matching, the relative risk of mortality in NORP patients was 0.34, and the risk of respiratory distress was 0.47. The mean level of pseudocholinesterase was significantly higher in the NORP group than in the ORP group, while recovery rates were similar between the two groups.
Although the majority of NORP patients were admitted to the ED with unintentional poisoning and the relative risk of NORP was lower than that for ORP, we concluded that NORP is as critical as ORP. Considerable medical observation and intensive therapeutic approaches are also needed for NORP patients.
常用于农业杀虫剂的有机磷化合物具有很高的中毒风险和发生率。在本研究中,我们调查了非口服途径中毒(NORP)患者与口服途径中毒(ORP)患者相比的相对风险和临床严重程度,包括实验室检查结果。
利用单一机构的毒理学数据库登记系统获取2000年1月至2016年10月期间到急诊科就诊的有机磷中毒患者的临床实验室检查结果信息。在整个队列中,使用1:2倾向评分匹配比较临床结局,如死亡率和并发症发生率。
在我们研究的总共273例患者中,34例经历了非口服途径中毒。经过1:2倾向评分匹配后,口服途径中毒组的呼吸并发症发生率和死亡率高于非口服途径中毒组。然而,两组之间的住院时间和在重症监护病房的停留时间没有差异。与匹配后的口服途径中毒患者相比,非口服途径中毒患者的相对死亡风险为0.34,呼吸窘迫风险为0.47。非口服途径中毒组的假性胆碱酯酶平均水平显著高于口服途径中毒组,而两组之间的恢复率相似。
尽管大多数非口服途径中毒患者因意外中毒被收入急诊科,且非口服途径中毒的相对风险低于口服途径中毒,但我们得出结论,非口服途径中毒与口服途径中毒一样严重。非口服途径中毒患者也需要相当的医学观察和强化治疗方法。