Document Detail


Acid-base interpretation can be the predictor of outcome among patients with acute organophosphate poisoning before hospitalization.
MedLine Citation:
PMID:  18082777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Acute organophosphate (OP) poisoning causing alteration in acid-base equilibrium was reported before. Hence, different acid-base statuses may present in patients with acute poisoning due to OP exposure. This study aims to determine the impact of acid-base interpretation in patients with acute OP poisoning before hospitalization in medical care units and to describe the pattern of mortality with different acid-base statuses. DESIGN AND PATIENTS: Over a 9-year retrospective study, from July 1996 to August 2005, a total of 82 consecutive patients with acute OP poisoning were admitted to the China Medical University Hospital (Taichung, Taiwan) within 24 hours after exposure to OP and were enrolled into this study. RESULTS: Patients with acute OP poisoning were divided into 4 groups: without acidosis, metabolic acidosis, respiratory acidosis, and mixed acidosis. Overall survival (Kaplan-Meier curves) among groups was statistically significant (P < .0001). The mortality rate of acute OP poisoned patients with metabolic acidosis was 25%, and 75% of those patients died of cardiovascular failure. The mortality rate of acute OP poisoning with respiratory acidosis was 50%, and 50% of those patients died of respiratory failure. CONCLUSIONS: Acid-base interpretation can be effective in quick diagnosis and prediction of the outcome of patients with acute OP poisoning (without acidosis < metabolic acidosis < respiratory acidosis < mixed acidosis) before hospitalization. Major causes of death are different between the respiratory acidosis and metabolic acidosis groups of patients with acute OP poisoning.
Authors:
Jiung-Hsiun Liu; Che-Yi Chou; Yao-Lung Liu; Pen-Yuan Liao; Po-Wen Lin; Hsin-Hung Lin; Ya-Fei Yang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  26     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-17     Completed Date:  2008-01-08     Revised Date:  2008-08-14    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  24-30     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Imbalance / chemically induced*,  mortality*
Acidosis / chemically induced,  mortality
Acidosis, Respiratory / chemically induced,  mortality
Adult
Aged
Blood Gas Analysis
Female
Hospitalization
Humans
Logistic Models
Male
Middle Aged
Phosphoric Acid Esters / poisoning*
Poisoning / mortality
Retrospective Studies
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Phosphoric Acid Esters
Comments/Corrections
Comment In:
Am J Emerg Med. 2008 Jul;26(6):721-2; author reply 722-3   [PMID:  18606331 ]
Am J Emerg Med. 2008 Jul;26(6):721; author reply 722-3   [PMID:  18606330 ]

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