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KMID : 0828520130170040198
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Journal of the Korean Geriatrics Society
2013 Volume.17 No. 4 p.198 ~ p.204
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The Features and Prognoses in Organophosphate Intoxication according to Age
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Lim Seung-Wook
Park Seung-Min
Lee Young-Hwan
Lee Won-Woong
Ahn Ji-Yun
Son Yoo-Dong
Ahn Hee-Cheol
Kim Hyun
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Abstract
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Background: The purpose of this study was to identify the factors that influence mortality in organophosphate intoxication and the differences between the elderly (≥65 years) and younger adults (18-64 years) looking at vital sign, length of admission, cholinesterase activity, complications, and prognosis.
Methods: All patients visiting one Emergency Department (ED) with organophophate intoxication between January 2000 and December 2011 were reviewed retrospectively. We divided the patients into two groups, geriatric adults (≥ 65 years) and nongeriatric adults (18-64 years).
Results: During the study period, 155 patients (45 patients, ≥65 years; 110 patients, 18-64 years) presented to the ED with organophosphate intoxication. Thirty-six elderly patients (80.0%) vs. 63 younger adult patients (57.3%) were intubated endotracheally, with the analysis showing a clear distinction between the two groups (p=0.026). Twenty-two elderly patients (48.9%) vs. 23 younger adult patients (20.9%) went into shock, displaying a significant gap (p=0.008). Thirtyfive elderly patients (81.4%) vs. 62 younger adult patients (59.0%) developed respiratory complications and 20 elderly patients (46.5%) vs. 19 younger adult patients (18.1%) developed central nervous system complications, with obvious differences seen in each of the comparison at (p=0.031) and (p=0.005), respectively. Comparing plasma cholinesterase levels at 1st, 3rd, 5th, 10th, 15th, and 20th days, the rate of increase was faster in the younger adults (p=0.022).
Conclusion: With organophosphate intoxication, elderly patients tended to be intubated endotracheally, went into shock, developed central nervous system complications, were more severe, and showed a slower increase in cholinesterase level.
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KEYWORD
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Cholinesterases, Aged, Organophosphate poisoning
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