Epidemiological, clinical characteristics and outcomes of patients presenting with acute organophosphorus poisoning to a tertiary care institution in North India
Organophosphates (OP) poisoning continues to be a major cause of deliberate self-harm and an important cause of morbidity and mortality in India. We aim to study the clinico-epidemiological features in patients presenting with OP poisoning. This prospective observational study involved 400 patients above 18 years of age admitted to the emergency department of a tertiary care institution in Northern India. The study cohort was graded into mild, moderate & severe based on the Peradeniya Organophosphorus Poisoning (POP) scale and degree of cholinesterase inhibition. The majority of patients (40%) in our study population were aged between 18–25 years. There was a significant female preponderance (82% vs. 18%; P=0.000). Suicide was the most common motive (93%) and ingestion was the most common mode of poisoning (99%). The muscarinic and nicotinic symptoms were common at the presentation. Seizures were present in 11% of patients. On the POP severity scale, mild, moderate and severe poisoning was seen at 50%, 35% and 15%, respectively. Cholinesterase inhibition was mild (>2 kU/L) in 31%, moderate (1–2 kU/L) in 46% and severe (<1 kU/L) in 23%. A total of 48% of patients had complications. Ventilator support was needed in 43% of the patients. An overall mortality of 18% was observed in the study. OP poisoning is a serious public health problem, but timely intervention may help to reduce morbidity and mortality, especially in a resource-limited country like India.