Base deficit is a predictor of mortality in organophosphate insecticide poisoning

Sh, Lee; Kang, Changwoo; Kim, D H; Kim, T; Jeong, J H; Kim, S C; Rhee, Dong Yoon; Lim, Dong Hoon

doi:10.1177/0960327117694073

Cited by 13 publications

(12 citation statements)

References 30 publications

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“…These results were consistent with previous studies as high creatinine found a signi cant factor of mortality in multiple Asian studies from 2013 to 2018 including one of our urban cities [13,17,22,26,39]. Two of Asian studies reported risk of mortality on univariable analysis, patients having high creatinine level founds seven to eight times more likely to die [21,40], whereas in our study patients in normal-increasing trajectory were eighteen times and high-declining were twelve times more likely to die compared to the normal consistent creatinine level. This may be due to the mortality within 30 days in these studies whereas in our study it was 20 days.…”

Section: Discussionsupporting

confidence: 91%

Latent Class Trajectories of Biochemical Parameters and Their Relationship With Risk of Mortality Among Acute Organophosphorus Poisoning Patients

Farooqui

Uddin

Qadeer

et al. 2021

Preprint

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Objectives: To determine varying biochemical parameters and their relationship with mortality among organophosphorus poisoning patients through a latent class trajectory analysis.Methods: It was a retrospective cohort study. Patients with organophosphorus poisoning (OP) were admitted to the Intensive Care Unit (ICU) of Ruth Pfau Civil Hospital Karachi from August 2010 to September 2016. A total of 299 OP poisoning patients’ data along with demographic and biochemical parameters were retrieved from medical records. The key outcome measure was in-hospital mortality among acute poisoning patients accounting for gender, age, elapse time since poison ingestion, ICU stay, and biochemical parameters including random blood sugar, creatinine, urea, and electrolytes (sodium, chloride, potassium). The trajectories of parameters were formed using longitudinal latent profile analysis. These trajectories and repeated measures were used as independent variables to determine and compare the risk of mortality by Cox-Proportional-Hazards models. A p-value of <0.05 was considered statistically significant.Results: A total of 299 patients’ data were included with a mean age of 25.4±9.7 years and in-hospital mortality was 13.7%(n=41). In trajectory analysis, patients with high-declining and normal-increasing creatinine, high-remitting, and normal-increasing urea, high-remitting sodium, trajectories observed the highest mortality i.e. 67%(2/3), 75%(6/8), 67%(2/3), 75%(6/8), and 80% (4/5) respectively compared with other trajectories. On multivariable analysis, patients in high-declining creatinine class were sixteen times [HR:15.7,95%CI:3.4-71.6], normal-increasing was fifteen times [HR:15.2,95%CI:4.2-54.6] more likely to die compared with those who had normal consistent creatinine levels. Patients in extremely high-remitting urea trajectory were fifteen times [HR:15.4,95%CI:3.4-69.7], normal-increasing urea trajectory was four times [HR:3.9,95%CI:1.4-11.5] and in high-remitting sodium, the trajectory was six times [HR:5.6,95%C.I:2.0-15.8] more likely to die compared with those who were in normal-consistent trajectories of urea and sodium respectively.Conclusion: Using the latent profile approach, biochemical parameters (creatinine, urea, and sodium levels) were significantly associated with increased risk of mortality among OP poisoning patients.

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Section: Discussionsupporting

confidence: 91%

Latent Class Trajectories of Biochemical Parameters and Their Relationship With Risk of Mortality Among Acute Organophosphorus Poisoning Patients

Farooqui

Uddin

Qadeer

et al. 2021

Preprint

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“…Consistent with our findings, another study demonstrated that the albumin concentration at presentation was inversely associated with the 30‐day hospital mortality rate according to the Cox proportional hazards model in 154 patients poisoned with OP. However, the authors did not comment on the association of albumin with the outcome because their research topic was the base deficit 20 . Lee JH et al showed a significantly lower albumin concentration in non‐surviving patients than in surviving patients after OP poisoning in univariate analysis 21 .…”

Section: Discussionmentioning

confidence: 99%

The clinical role of serum albumin in Organophospate poisoning

Noh

Moon

Chun

et al. 2020

Basic Clin Pharma Tox

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This retrospective study investigated whether the serum albumin (SA) concentration at presentation is associated with mortality and the mechanism underlying the association. This study enrolled 217 patients poisoned with organophosphate (OP). Hypoalbuminemia (albumin <3.5 g/dL) at presentation was identified in 18.4% of the patients poisoned with OP. The hypoalbuminemia group experienced a more complicated clinical course and had a higher mortality rate than the normoalbuminemia and hyperalbuminemia groups. The SA concentration correlated with the CRP level at presentation but not with the body mass index in patients with OP poisoning. Furthermore, the change in the SA concentration during the first 24 hours also correlated with the change in BuChE activity in patients with fenitrothion poisoning. The SA concentration at presentation was independently associated with mortality after adjusting for inflammation and nutritional status. This study showed that the SA concentration at presentation is associated with the mortality risk of patients poisoned with OP. This association is independent of inflammation and nutritional status in OP poisoning, and in particular, the protective effect of SA might contribute to this association in fenitrothion poisoning. These results should be validated.

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“…17 In addition, previous studies have shown that acute organophosphate poisoning is a predictive factor of severity and mortality, and it may be expressed using APACHE II, BD, and RDW. 11,12,27 Patients with ethylene glycol, methanol, and cyanide poisoning have high AG levels in plasma. [21][22][23] The acid-base status predicts the survival of the poisoned patients.…”

Section: Discussionmentioning

confidence: 99%

“…prolongation of heart rate-corrected QT interval). [11][12][13][14][15][16] The anion gap (AG) is a predictive factor in patients with acute pesticide poisoning. 17 Age >50 years, X-ray abnormalities, and alanine aminotransferase (ALT) >40 U/L were significant predictive factors for complications in patients with glyphosate surfactant herbicide poisoning.…”

Section: Introductionmentioning

confidence: 99%

Anion gap and base deficit are predictors of mortality in acute pesticide poisoning

Kim

et al. 2018

Hum Exp Toxicol

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Background: Acute pesticide poisoning has long been a serious problem as a method of suicide worldwide. This poisoning is a highly fatal condition that requires a rapid and precise diagnosis for adequate treatment. However, various studies on mortality predictor factors have been insufficient for whole pesticide treatments. We hypothesized that the initial plasma anion gap (AG) and base deficit (BD) are reliable prognostic factors. Methods: A retrospective study analyzed 561 patients with a diagnosis of acute pesticide poisoning between January 1, 2014 and June 30, 2017. The initial AG and BD values were divided into quartiles according to the number of patients. Survival at 30 days from admission was estimated using the Kaplan–Meier survival analysis. Receiver-operator characteristic (ROC) curves were drawn, and the areas under the curve for AG and BD for mortality were calculated. Results: Fifty-eight (10.3%) of 561 patients died within 30 days. The highest AG quartile (>22 mEq/L) was associated with an increased risk of 30-day hospital mortality. Compared to patients with an AG less than 14.7 mEq/L, these patients had a 4.18-fold higher risk of 30-day hospital mortality and the highest BD quartile (>7.9 mEq/L) was associated with an increased risk of 30-day hospital mortality. Compared to patients with a BD less than 1.4 mEq/L, these patients had 2.23-fold higher risk of 30-day hospital mortality. The areas under the ROC for AG and BD curve were 0.699 and 0.744, respectively. Conclusions: Initial high AG and BD values could predict mortality and require precise intensive care.

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Base deficit is a predictor of mortality in organophosphate insecticide poisoning

Abstract: This study showed that the BD is a predictor of 30-day mortality in patients with OPI poisoning.

Cited by 13 publications

References 30 publications

Latent Class Trajectories of Biochemical Parameters and Their Relationship With Risk of Mortality Among Acute Organophosphorus Poisoning Patients

Latent Class Trajectories of Biochemical Parameters and Their Relationship With Risk of Mortality Among Acute Organophosphorus Poisoning Patients

The clinical role of serum albumin in Organophospate poisoning

Anion gap and base deficit are predictors of mortality in acute pesticide poisoning

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