Predictors of Morbidity and Mortality in Organophosphorous Compound Poisoning at a Tertiary Care Hospital in Karnataka

Background Poisoning is a significant global public health problem. According to World Health Organisation, in 2012 an estimated 1, 93, 460 people died worldwide from unintentional poisoning causing a loss of over 10.7 million DALYs (disability adjusted life years). In India, organophosphorous (OP) poisonings form a majority of acute poisoning cases in rural and sub urban areas. Material and Methods A total of 65 patients admitted above the age of 18 years, with a history of ingestion or inhalation of organophosphorus compounds were included in the study. Data were presented either as mean standard deviation (SD) or as percentages. Probability values of P less than 0.05 were taken as significant. Results 44 (67.7 %) were males and 21 (32.3 %) were females. Over half of the patients, thirty three in number (50.76 %), were young adults in the age group of 21-33 years. Majority i. e.30 (46.2 %) presented to the hospital 2-4 hrs after consumption. (41.5 %) of the patients required mechanical ventilation with a mean duration of 3.55 + 2.72 (n+SD) days among whom 15 (23.07 %) required ventilation for less than 4 days and 12 (18.46 %) required ventilation for greater than 4 days respectively. A significant correlation (p=0.023) was found between lower serum pseudocholinesterase levels (8 days). A significantly lower mean s. pseudocholinesterase level of 605.33 IU was found in those who died as compared to 2699.91 IU among those who survived (p=0.042). Conclusion Serum pseudocholinesterase levels can guide decision making with regard to need of intensive care management and can aid in predicting duration of intensive care needed and hospital stay.