Epidemiological, clinical characteristics and outcomes of patients presenting with acute organophosphorus poisoning to a tertiary care institution in North India

Mohammad Hayat Bhat; Sajad Qadir Bhat; Ishrat Hussain Dar; Mohammad Afaan Bhat; Javaid Ahmad Bhat

Mohammad Hayat Bhat Department of Endocrinology, Superspeciality Hospital, Srinagar, Kashmir, India
Sajad Qadir Bhat Department of Medicine, Government Medical College, Srinagar, Kashmir, India
Ishrat Hussain Dar Department of Medicine, Government Medical College, Srinagar, Kashmir, India
Mohammad Afaan Bhat Department of Medicine, Government Medical College, Srinagar, Kashmir, India
Javaid Ahmad Bhat Department of Endocrinology, Superspeciality Hospital, Srinagar, Kashmir, India

Keywords: organophosphorus poisoning, epidemiology, mortality, morbidity, glycemic status

Abstract

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.