title: Prognostic Factors in Cholinesterase Inhibitor Poisoning.
abstract: BACKGROUND
  Organophosphates and carbamates are insecticides that are associated with high human mortality. The purpose of this study is to investigate the prognostic factors affecting survival in patients with cholinesterase inhibitor (CI) poisoning.
  
  
  METHODS
  This study included 92 patients with CI poisoning in the period from January 2005 to August 2013. We divided these patients into 2 groups (survivors vs. non-survivors), compared their clinical characteristics, and analyzed the predictors of survival.
  
  
  RESULTS
  The mean age of the included patients was 56 years (range, 16-88). The patients included 57 (62%) men and 35 (38%) women. When we compared clinical characteristics between the survivor group (n=81, 88%) and non-survivor group (n=11, 12%), there were no differences in renal function, pancreatic enzymes, or serum cholinesterase level, except for serum bicarbonate level and APACHE II score. The serum bicarbonate level was lower in non-survivors than in survivors (12.45±2.84 vs. 18.36±4.73, P<0.01). The serum APACHE II score was higher in non-survivors than in survivors (24.36±5.22 vs. 12.07±6.67, P<0.01). The development of pneumonia during hospitalization was higher in non-survivors than in survivors (n=9, 82% vs. n=31, 38%, P<0.01). In multiple logistic regression analysis, serum bicarbonate concentration, APACHE II score, and pneumonia during hospitalization were the important prognostic factors in patients with CI poisoning.
  
  
  CONCLUSIONS
  Serum bicarbonate and APACHE II score are useful prognostic factors in patients with CI poisoning. Furthermore, pneumonia during hospitalization was also important in predicting prognosis in patients with CI poisoning. Therefore, prevention and active treatment of pneumonia is important in the management of patients with CI poisoning.
authors.affiliation: Division of Nephrology and Toxicology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea.
authors.forename: In O
authors.initials: IO
authors.lastname: Sun
authors.affiliation: Division of Nephrology and Toxicology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: Division of Nephrology and Toxicology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea.
authors.forename: Kwang Young
authors.initials: KY
authors.lastname: Lee
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001639:Bicarbonates / Q000097:blood; D002800:Cholinesterase Inhibitors / Q000506:poisoning*; D002802:Cholinesterases / Q000097:blood; D005260:Female; D006760:Hospitalization; D006801:Humans; D007668:Kidney / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000201:enzymology; D011014:Pneumonia / Q000150:complications; D011041:Poisoning / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001639:Bicarbonates; D002800:Cholinesterase Inhibitors; D002802:Cholinesterases