Clinical Profile and Outcome of Organophosphorus Poisoning at Tertiary Care Centre in Western Maharashtra

Organophosphorus (OP) compounds are the most common suicidal poison in developing countries and mortality is high. In Maharashtra state, India the widespread use of organophosphates (OPs) in agricultural and household environments results in numerous OP poisoning.

Total 97 patients admitted in medical intensive care unit between January 2010 to December 2010 at Krishna Institute of medical sciences Karad, were included in this retrospective study.

Out of total 97 patients with OP poisoning 57 (58.76%) were males and 40 (41.23%) were females. Patients those who succumbed to death had mean time of consumption of OP and institution of treatment was >6 hours which was high compared to those who survived (‘p’<0.01). Total 56 (57.73%) patients were required ventilatory support of which 36 (63.15%) were for >7 days and 20 (36.85%) for <7 days. Acute cholinergic crisis was present in 41 (42.26%) patients and intermediate syndrome was present in 34 (35.05%) patients. Dimethoate (12/9) had highest mortality compared to other OPs with ‘p’ <0.001. Total 12(21.05%) male and 5 (12.5%) female patients developed ventilator associated pneumonia with ARDS. Total 10 (16. 94%) patients have developed central venous catheter related infection. Delayed peripheral predominant motar neuropathy was seen in 2 (2.06%) patients.

There was significantly high mortality in moderate and severe type of OP poisoning (15.46%). The low mean serum cholinesterase level was significantly correlated with delayed admission and institution of treatment, fasciculation's, acute cholinergic crisis, intermediate syndrome and nosocomial infections. Dimethoate poisoning associated with highest mortality.