Prevalence and management outcomes of organophosphorus poisoning in emergency departments: systematic review

Abstract

Organophosphorus poisoning (OPP) is a significant public health concern in various regions, with its prevalence and outcomes influenced by diverse sociodemographic factors. This systematic review aimed to collate and analyze data from multiple studies to provide a comprehensive understanding of the prevalence, risk factors, and management outcomes of OPP in emergency departments. A systematic search was conducted in October 2023, adhering to the PRISMA guidelines, primarily using PubMed. Studies were selected based on specific inclusion and exclusion criteria, with a focus on those that investigated OPP prevalence and management outcomes in emergency departments. Out of 87 initial studies, 9 met the inclusion criteria, encompassing a total of 1,469 participants from countries like Nepal, India, Korea, China, and Turkey. The studies predominantly included the younger to middle-aged demographic, with a significant male representation indicating that young males. Key findings highlighted the role of pesticides, especially organophosphorus compounds, in intentional poisonings, which can be seen more in young and unmarried females. Additionally, the therapeutic efficacy of treatments like plasma exchange has proven to be another promising tool for management. Finally, the importance of specific prognostic indicators such as D-CRP and the sequential organ failure assessment (SOFA) score, when combined with lactate levels (SOFA-Lac), are superior predictors of mortality in patients with acute organophosphate pesticide poisoning. The insights from this review emphasize the need for targeted interventions, both therapeutic and preventive, to address the challenges posed by OPP, especially in high-risk populations.