English

Abstract

BACKGROUND: Organophosphorus compound poisoning is a global problem and is most common medico toxic emergency in India and is associated with high rate of mortality, if not diagnosed early and treated adequately. We studied clinical profile, electrocardiographic changes and electrolyte derangements in patients with organophophorus compound poisoning. METHODOLOGY: We studied randomly selected 100 patients of organophosphorus compound poisoning admitted within 12 hours of consumption. Clinical profile, electrocardiographic changes and serum electrolytes derangements were analyzed on outcome basis. RESULT: In this study, most vulnerable age group was between 12-30 years (46%), male to female ratio is 3.17:1. Majority of patient belongs to rural areas (54%) and 66% patient belongs to low socioeconomic status. In all the patients mode of exposure was suicidal and route of intake oral, commonest symptom found was vomiting (46%) and commonest sign was smell of poison (96%). Type of organophosphate was identified in 60% and unidentified in 40% patient. Monocrotophos (30%) was most common compound among identified group. Majority of patients (52%) were hospitalized within 2-4 hrs of organophosphate compound consumption and total hospital stay was 6-10 days in 61% patient. Electrocardiographic changes were detected in 54% patient; most common electrocardiographic change was sinus tachycardia (29%), QTc prolongation (28%), ST-T wave changes (22%) sinus bradycardia (21%), conduction defects (4%) and Arrhythmia (VT) (3%). Mortality rate in present study is 16%, mortality rate among patient with prolonged QTc interval was 50%, and was statistically significant when compared with mortality of 2.78% in those with normal QTc interval (x2=33.41, P < 0.001). Serum electrolyte derangements (Na+, K+, Ca++) were found statistically insignificant in present study. CONCLUSION: Estimation of electrocardiographic changes will be useful parameter in assessing prognosis of organophosphate compound poisoning patients. ECG changes like QTc prolongation are potentially dangerous and indicate the necessity of continuous cardiac monitoring. Serum electrolytes derangements are not helpful in assessing prognosis in organophosphorus compound poisoning