Epidemiology of organophosphate intoxication and predictors of intermediate syndrome

Abstract

Aim: To evaluate the usefulness of plasma glucose and serum cholinesterase levels as predictors of organophosphate-induced intermediate syndrome. Materials and methods: Seventy-one organophosphate poisoning patients who were admitted to our emergency department during a 4-year period were evaluated retrospectively. Four patients were excluded from the study due to a lack of medical records. Categorical variables were analyzed using the chi-square test and nonparametric variables were analyzed using the Mann-Whitney U test. Results: Thirty-five (52.2%) patients were male and 32(47.8%) were female. Patients had a mean age of 39.4 +/- 15.9 years and 70.1% of the patients were married. Oral intake (68.7%) was the most common method of intoxication, and attempted suicide (67.2%) was the most common cause. The most common organophosphates were methamidophos (20.8%), dichlorvos (19.4%), parathion (7.5%), and methyl parathion (7.5%). Fifty-seven (85%) patients were treated in the emergency observation unit and 10 (15%) patients were admitted to the intensive care unit. Eleven (16%) patients developed intermediate syndrome and had significantly lower levels of serum cholinesterase (P < 0.01) and higher blood glucose levels (P = 0.037). Conclusion: Initial serum cholinesterase and glucose levels measured in the emergency department may be a useful marker in predicting organophosphate-induced intermediate syndrome.