Abstract
Objective: Previous research has demonstrated that patients with a history of organophosphate poisoning tend to have a higher risk of neurological disorder. However, research on the rate of seizure development in patients after organophosphate poisoning is lacking. This study examined whether individuals with organophosphate poisoning have an increased risk of seizures through several years of follow-up. Patients and Methods: We conducted a retrospective study on a cohort of 45,060 individuals (9012 patients with a history of organophosphate poisoning and 36,048 controls) selected from the Taiwan National Health Insurance Research Database. The individuals were observed for a maximum of 12 years to determine the rate of new-onset seizure disorder. We selected a comparison cohort from the general population that was randomly frequency-matched by age, sex, and index year and further analyzed the risk of seizures using a Cox regression model adjusted for sex, age, and comorbidities. Results: During the study period, the risk of seizure development was 3.57 times greater in patients with organophosphate poisoning compared with individuals without, after adjustments for age, sex, and comorbidities. The absolute incidence of seizures was highest in individuals aged 20 to 34 years in both cohorts (adjusted hazard ratio = 13.0, 95% confidence interval = 5.40−31.4). A significantly higher seizure risk was also observed in patients with organophosphate poisoning and comorbidities other than cirrhosis. Conclusions: This nationwide retrospective cohort study demonstrates that seizure risk is significantly increased in patients with organophosphate poisoning compared with the general population.
Highlights
Most patients exposed to organophosphates came into contact with insecticides
During the study period, the risk of seizure development was 3.57 times greater in patients with organophosphate poisoning compared with individuals without, after adjustments for age, sex, and comorbidities
A significantly higher seizure risk was observed in patients with organophosphate poisoning and comorbidities other than cirrhosis
Summary
The present study was conducted using the Taiwan National Health Insurance Research Database (NHIRD). The NHI program was implemented in Taiwan on 1 March 1995. In 1999, as part of the NHIRD project, the Bureau of NHI began to release patient data in an electronic format for research purposes. These de-identified secondary data include all registry and claims data. We used the hospitalization claims data of all enrollees in Taiwan, including sex, birth date, dates of admission and discharge, diagnoses, operations, discharge statuses, and expenditures by admission. Because the data set consists of de-identified secondary data, the study was exempted from full review by the Institutional Research Ethics Committee (CMUH104-REC2-115-CR4)
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