Glasgow Coma Scale score and QTc interval in the prognosis of organophosphate poisoning.
OBJECTIVE
The aim of this study was to assess the applicability of the Glasgow Coma Scale (GCS) score and the Q-T interval corrected for heart rate (QTc interval) in predicting outcome and complications in patients with organophosphate (OP) poisoning.


METHODS
This prospective, observational study included 65 patients older than 18 years. In the out-of-hospital setting, the end-tidal carbon dioxide (ETCO2), oxygen saturation (SaO2), QTc interval, and GCS score were monitored in each patient. A statistical comparison was then made between the group with respiratory failure and the group without this complication.


RESULTS
The group with complications had significantly different values of measured parameters--a longer QTc interval and a lower GCS score, a higher number of intubations, and worse outcomes (p < 0.05). The two measures, GCS score and QTc interval, have been shown to be equally good in predicting respiratory failure and hospital mortality in patients with OP poisoning.


CONCLUSIONS
In the initial out-of-hospital care of patients with OP poisoning, it is essential to monitor QTc interval and GCS score. These measures help with prognosis, and may suggest when to initiate precautions to prevent complications (i.e., respiratory failure). The simplicity and promptness of these methods allow providers to perform early and effective triage.
Grmec
Stefek
S
Center for Emergency Medicine Maribor, Maribor, Slovenia.
Mally
Stefan
S
Klemen
Petra
P
D018806:APACHE; D002802:Cholinesterases / Q000097:blood; D004562:Electrocardiography; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D062025:Organophosphate Poisoning; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D012680:Sensitivity and Specificity
D002802:Cholinesterases