The Features and Prognoses in Organophosphate Intoxication according to Age |
Seung Wook Lim, Seung Min Park, Young Hwan Lee, Won Woong Lee, Ji Yun Ahn, You Dong Sohn, Hee Cheol Ahn, Hyun Kim |
1Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. aukawa@hallym.or.kr 2Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. |
유기인계 중독 환자에서 연령에 따른 특징 및 예후 |
임승욱1⦁박승민1⦁이영환1⦁이원웅1⦁안지윤1⦁손유동1⦁안희철1⦁김 현2 |
한림대학교 의과대학 응급의학교실1, 연세대학교 원주의과대학 응급의학교실2 |
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Abstract |
BACKGROUND The purpose of this study was to identify the factors that influence mortality in organophosphate intoxication and the differences between the elderly (> or =65 years) and younger adults (18-64 years) looking at vital sign, length of admission, cholinesterase activity, complications, and prognosis. METHODS All patients visiting one Emergency Department (ED) with organophophate intoxication between January 2000 and December 2011 were reviewed retrospectively. We divided the patients into two groups, geriatric adults (> or = 65 years) and nongeriatric adults (18-64 years). RESULTS During the study period, 155 patients (45 patients, > or =65 years; 110 patients, 18-64 years) presented to the ED with organophosphate intoxication. Thirty-six elderly patients (80.0%) vs. 63 younger adult patients (57.3%) were intubated endotracheally, with the analysis showing a clear distinction between the two groups (p=0.026). Twenty-two elderly patients (48.9%) vs. 23 younger adult patients (20.9%) went into shock, displaying a significant gap (p=0.008). Thirtyfive elderly patients (81.4%) vs. 62 younger adult patients (59.0%) developed respiratory complications and 20 elderly patients (46.5%) vs. 19 younger adult patients (18.1%) developed central nervous system complications, with obvious differences seen in each of the comparison at (p=0.031) and (p=0.005), respectively. Comparing plasma cholinesterase levels at 1st, 3rd, 5th, 10th, 15th, and 20th days, the rate of increase was faster in the younger adults (p=0.022). CONCLUSION With organophosphate intoxication, elderly patients tended to be intubated endotracheally, went into shock, developed central nervous system complications, were more severe, and showed a slower increase in cholinesterase level. |
Key Words:
Cholinesterases, Aged, Organophosphate poisoning |
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