Acid-base interpretation can be the predictor of outcome among patients with acute organophosphate poisoning before hospitalization.
OBJECTIVE
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.


METHODS
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.
Liu
Jiung-Hsiun
JH
Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Chou
Che-Yi
CY
Liu
Yao-Lung
YL
Liao
Pen-Yuan
PY
Lin
Po-Wen
PW
Lin
Hsin-Hung
HH
Yang
Ya-Fei
YF
D000137:Acid-Base Imbalance / Q000139:chemically induced* / Q000401:mortality*; D000138:Acidosis / Q000139:chemically induced / Q000401:mortality; D000142:Acidosis, Respiratory / Q000139:chemically induced / Q000401:mortality; D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D062025:Organophosphate Poisoning; D011041:Poisoning / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome