TMH, Jamshedpur.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Organophosphate compounds (OPC) cause most selfpoisoning deaths in India due to their easy availability and lack of stringent laws.
To evaluate the clinical profile and outcome of the patients presenting with OPC poisoning and to study the prognostic value of Peradeniya Organophosphorus Poisoning Scale (POPS) in predicting the clinical outcomes.
This was a prospective study involving 100 patients of OPC poisoning admitted to Tata Main Hospital from June 2018 to May 2020 based on the inclusion criteria. Demographic profile, clinical features, treatment details, and need for ventilatory support were noted. POPS was applied on admission, and the patients were followed up for the outcome in terms of morbidity and mortality.
Of the 100 patients, most patients were between 20 and 29 years with male to female ratio being 1.2:1. Vomiting (94%), followed by excessive secretions (84%) were the most common symptoms. Overall mortality was 22%. On grading of severity as per the POP scale, 27% of the patients had mild poisoning, 37% patients had moderate, whereas 36% had severe poisoning. Only 11.11% of the patients with POPS 0-3 required ventilator support, whereas 16.2% of the patients with POPS 4-7, and 100% of patients with POPS 8-11 required ventilator assistance (P < 0.0001). Similarly, the total dose of atropine required (P < 0.0001), length of intensive care unit (ICU) stay, complications, and mortality (P < 0.0001) were significantly associated with higher POPS.
POPS at admission, correlated well with the need for ventilator support, the total dose of atropine required, length of stay in the ICU, complications, and mortality. It can thus be used for prognostication and risk stratification of patients with OPC poisoning.
评估因有机磷化合物(OPC)容易获得且缺乏严格法律而在印度导致大多数自杀性中毒死亡的患者的临床特征和结局,并研究佩拉德尼亚有机磷中毒严重程度评分(POPS)在预测临床结局方面的预后价值。
这是一项前瞻性研究,纳入了 2018 年 6 月至 2020 年 5 月期间根据纳入标准入住塔塔主医院的 100 名 OPC 中毒患者。记录人口统计学特征、临床特征、治疗细节和对通气支持的需求。入院时应用 POPS,随访患者的发病率和死亡率。
100 名患者中,大多数患者年龄在 20 至 29 岁之间,男女比例为 1.2:1。最常见的症状是呕吐(94%),其次是过度分泌(84%)。总死亡率为 22%。根据 POPS 分级,27%的患者为轻度中毒,37%的患者为中度中毒,36%的患者为重度中毒。仅 11.11%的 POPS 0-3 患者需要呼吸机支持,而 POPS 4-7 的患者为 16.2%,POPS 8-11 的患者为 100%需要呼吸机辅助(P < 0.0001)。同样,需要的阿托品总剂量(P < 0.0001)、入住重症监护病房(ICU)的时间、并发症和死亡率(P < 0.0001)与较高的 POPS 显著相关。
入院时的 POPS 与对呼吸机支持的需求、所需阿托品的总剂量、入住 ICU 的时间、并发症和死亡率密切相关。因此,它可用于预测和对 OPC 中毒患者进行风险分层。