Predictive Value of Triage Vital Signs and Conscious Level for Outcome Evaluation in Acutely Organophosphate Poisoned Patients

Abstract

Triage in Emergency departments requires emergency doctors to make rapid decisions based on their knowledge and experiences. Triage of patients is critical to patient safety, yet no clear information exists by the utility of initial vital signs and conscious level in identifying critically ill acutely organophosphate (OP) poisoned patients. The objective of this study is to determine the relationship between triage vital signs and conscious level in predicting outcome of acutely organophosphate poisoned patients. A retrospective and prospective study was carried out on 200 patients of acute OP poisoning admitted to the Poison Control Center (PCC), Ain Shams University Hospitals. Information including vital signs and Glasgow coma scale (GCS) on admission after obtaining the permission of the director of PCC and the regional ethics committee was collected from the sheets and computerized data base of the patients, an informed written consent has been obtained from each patient or from his/her caregiver for inclusion in the prospective part of the study. The results were revised, coded and organized for statistical analysis. The study results revealed 180 (90%) patients discharged and 20 (10%) patients died. The study also showed that 8% of patients had fever, 9.5% had tachycardia, 1.5% had bradycardia, 5% had hypotension, 2% had hypertension, 2.5% had tachypnea and 3.5% showed bradypnea. Also 89% of patients had GCS > 8, while 11% of patients had GCS ≤ 8. The study showed statistically significant difference between discharged and died patients as regards heart rate, blood pressure, respiratory rate, body temperature and GCS. It could be concluded that heart rate, respiratory rate and coma scale can serve as easily measurable tools for outcome prediction in acutely OP poisoned patients. From the previous results, our study recommends to use these parameters to help emergency physicians to quickly detect poisoned patients with poor outcomes.

Trajectories of vital status parameters and risk of mortality among acute organophosphorus poisoning patients – a latent class growth analysis

“…LCGA in our study indicated that the highremitting trajectory of respiratory rate was linked to mortality. However, these results were in contrast with previous studies, as high temperature and low respiratory rate have exhibited significance with mortality in multiple studies [26,47,49,50], though nonsignificance for respiratory rate [47] and temperature [48] was observed in a study of OP poisoning patients. Multiple studies have investigated vital signs but not PO 2 [47,50,51], whereas our study showed that a normal-remitting partial oxygen pressure trajectory is linked to an increased risk of mortality.…”

The role of cortisol and thyroid stimulating hormone in prognosis of acute anticholinesterase pesticides poisoned patients admitted to Tanta Poison Control Center

“…Regarding respiratory rate, abnormalities were recorded in 27.6 % of patients (20.7% had tachypnea, 6.9% with bradypnea). Other studies as Banerjee et al, (2012) and Moussa et al, (2018) reported that tachypnea represented 6%, 35% of cases respectively. Tachypnea may be a sign of respiratory failure (Sungur and Güven, 2001).…”

“…This is explained by Rabha et al, (2017) as preganglionic nicotinic receptor stimulation was followed by release of adrenaline and noradrenaline from adrenal gland leading to predominance of adrenergic activity on the heart. Moussa et al, (2018) found that 9.5% of patients presented with tachycardia and 1.5% of patients presented with bradycardia. Concerning the blood pressure, they found 5% of their patients had hypotension, 2% of patients had hypertension.…”

Role of Paraoxonase-1 Enzyme in Prediction of Severity and Outcome of Acute Organophosphorus Poisoning: A Prospective Study

“…The mortality rate in the Amin et al ( 2018) study was 11.53%. Also, Moussa et al (2018) study reported mortality rate by 10 %. Furthermore, Abdel Baseer et al (2021) reported that mortality rate was 5.5%.…”