Outcomes of elderly patients with organophosphate intoxication.

Autor: Yu JR; Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan., Hou YC; Division of Nephrology, Department of Internal Medicine, Cardinal Tien Hospital, and School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan., Fu JF; Department of Medical Research, Chang Gung Memorial Hospital, Linkou, and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan., Wang IK; Department of Nephrology, China Medical University Hospital, China Medical University, Taichung, Taiwan., Chan MJ; Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan., Chen CY; Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan., Weng CH; Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan., Huang WH; Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan., Yang HY; Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan., Hsu CW; Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan., Yen TH; Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, 199 Tung Hwa North Road, Taipei, Taoyuan, 105, Taiwan. m19570@adm.cgmh.org.tw.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2021 Jun 02; Vol. 11 (1), pp. 11615. Date of Electronic Publication: 2021 Jun 02.
DOI: 10.1038/s41598-021-91230-2
Abstrakt: This study analysed the clinical patterns and outcomes of elderly patients with organophosphate intoxication. A total of 71 elderly patients with organophosphate poisoning were seen between 2008 and 2017. Patients were stratified into two subgroups: survivors (n = 57) or nonsurvivors (n = 14). Chlorpyrifos accounted for 33.8% of the cases, followed by methamidophos (12.7%) and mevinphos (11.3%). Mood, adjustment and psychotic disorder were noted in 39.4%, 33.8% and 2.8% of patients, respectively. All patients were treated with atropine and pralidoxime therapies. Acute cholinergic crisis developed in all cases (100.0%). The complications included respiratory failure (52.1%), aspiration pneumonia (50.7%), acute kidney injury (43.7%), severe consciousness disturbance (25.4%), shock (14.1%) and seizures (4.2%). Some patients also developed intermediate syndrome (15.5%) and delayed neuropathy (4.2%). The nonsurvivors suffered higher rates of hypotension (P < 0.001), shock (P < 0.001) and kidney injury (P = 0.001) than survivors did. Kaplan-Meier analysis indicated that patients with shock suffered lower cumulative survival than did patients without shock (log-rank test, P < 0.001). In a multivariate-Cox-regression model, shock was a significant predictor of mortality after intoxication (odds ratio 18.182, 95% confidence interval 2.045-166.667, P = 0.009). The mortality rate was 19.7%. Acute cholinergic crisis, intermediate syndrome, and delayed neuropathy developed in 100.0%, 15.5%, and 4.2% of patients, respectively.
Databáze: MEDLINE
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