Epidemiology of organophosphate intoxication and predictors of intermediate syndrome

Turk J Med Sci. 2014;44(2):279-82. doi: 10.3906/sag-1211-31.

Abstract

Aim: To evaluate the usefulness of plasma glucose and serum cholinesterase levels as predictors of organophosphate-induced intermediate syndrome.

Materials and methods: Seventy-one organophosphate poisoning patients who were admitted to our emergency department during a 4-year period were evaluated retrospectively. Four patients were excluded from the study due to a lack of medical records. Categorical variables were analyzed using the chi-square test and nonparametric variables were analyzed using the Mann-Whitney U test.

Results: Thirty-five (52.2%) patients were male and 32(47.8%) were female. Patients had a mean age of 39.4 ± 15.9 years and 70.1% of the patients were married. Oral intake (68.7%) was the most common method of intoxication, and attempted suicide (67.2%) was the most common cause. The most common organophosphates were methamidophos (20.8%), dichlorvos (19.4%), parathion (7.5%), and methyl parathion (7.5%). Fifty-seven (85%) patients were treated in the emergency observation unit and 10 (15%) patients were admitted to the intensive care unit. Eleven (16%) patients developed intermediate syndrome and had significantly lower levels of serum cholinesterase (P < 0.01) and higher blood glucose levels (P = 0.037).

Conclusion: Initial serum cholinesterase and glucose levels measured in the emergency department may be a useful marker in predicting organophosphate-induced intermediate syndrome.

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Cholinesterase Reactivators / therapeutic use
  • Cholinesterases / blood
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • Muscle Weakness / chemically induced
  • Organophosphate Poisoning / blood
  • Organophosphate Poisoning / epidemiology*
  • Organophosphate Poisoning / therapy
  • Oximes / therapeutic use
  • Patient Admission / statistics & numerical data
  • Respiratory Paralysis / chemically induced
  • Retrospective Studies
  • Suicide, Attempted / statistics & numerical data
  • Turkey / epidemiology
  • Vomiting / etiology

Substances

  • Blood Glucose
  • Cholinesterase Reactivators
  • Oximes
  • Cholinesterases