head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing
ISSN: 1312-773X (Online)
Issue: 2017, vol. 23, issue 2
Subject Area: Medicine - Toxicology
DOI: 10.5272/jimab.2017232.1575
Published online: 31 May 2017

Original article

J of IMAB 2017 Apr-Jun;23(2):1575-1578
Petko Marinov1,4, Snezha Zlateva1,4, Dobri Ivanov2, Georgi Bonchev1ORCID logoCorresponding Autoremail, Yulichka Sabeva4, Kaloyan Georgiev3, Ivaylo Vazharov5,
1) Clinic for Intensive Treatment of Acute Intoxications and Toxicoallergies, Naval Hospital – Varna, Military Medical Academy, Bulgaria
2) Department of Biology, Faculty of Pharmacy, Medical University – Varna, Bulgaria
3) Department of Pharmaceutical Technologies, Faculty of Pharmacy, Medical University – Varna, Bulgaria
4) Department of Pharmacology, Toxicology and Pharmacotherapy, Faculty of Pharmacy, Medical University – Varna, Bulgaria
5) Clinic of Internal Diseases, Naval Hospital – Varna, Military Medical Academy, Bulgaria.

Purpose: Several criteria have been suggested to estimate the intoxication severity, yet so far no system of clinical criteria has been developed to determine the duration of hospitalisation. The forecast is linked to the influence of the extended corrected QT interval and GCS (Glasgow Coma Scale) on the frequency of the developing acute pulmonary insufficiency and lethality. The average duration of hospital treatment is also crucial. First of all, it is determined by the intoxication severity and lasts from 3 to 26 days. The aim of this study is to develop an individual forecast about the duration of hospitalisation for patients suffering from acute exogenous intoxication with organophosphorus pesticides (OPP).
Materials/Methods: The subjects are 160 patients. We use statistical regression analysis to study the significance of 5 of the most typical clinical indicators of organophosphorus intoxication on the duration of hospitalisation: type of conscience, presence of spasms, pulmonary oedema, shock and multi-organ insufficiency syndrome (MOIS). To forecast the treatment length, we obtain simplified mathematical expressions in the form of score estimates.
Results: The significance of the clinical indicators “MOIS”, “conscience” and “spasm” has been confirmed. A forecast matrix that gives the opportunity to forecast the personal duration of hospital treatment for each patient has been built.

Keywords: organophosphates, acute poisoning, duration of hospital treatment, prognosis,

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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Marinov P, Zlateva S, Ivanov D, Bonchev G, Sabeva Y, Georgiev K, Vazharov I. Acute exogenous intoxication with organophosphorus pesticides: duration of the hospital treatment and clinical criteria for prognosis. J of IMAB. 2017 Jan-Mar;23(2):1575-1578. DOI: 10.5272/jimab.2017232.1575

Corresponding AutorCorrespondence to: Georgi Bonchev, PhD, Head, Laboratory of Analytical Toxicology, Military Medical Academy, Naval Hospital – Varna; 3, Hristo Smirnenski Blvd., 9010 Varna, Bulgaria; E-mail: toxilab.varna@abv.bg

1. Chien WC, Chung CH, Jaakkola JJ, Chu CM, Kao S, Su SL, et al. Risk and prognostic factors of inpatient mortality associated with unintentional insecticide and herbicide poisonings: a retrospective cohort study. Plos One. 2012 Sep;7(9):e45627. [Internet]
2. Cander B, Dur A, Yildiz M, Koyuncu F, Girisgin AS, Gul M, et al. The prognostic value of the Glasgow coma scale, serum acetylcholinesterase and leucocyte levels in acute organophosphorus poisoning. Ann Saudi Med. 2011 Mar-Apr;31(2):163-6. [PMC]
3. Christakis-Hampsas M, Tutudakis M, Tsatsakis AM, Assithianakis P, Alegakis A, Katonis PG, et al. Acute poisoning and sudden deaths in Grete: a five year review (1991-1996). Vet Hum Toxicol. 1998 Aug;40(4):228-30. [PubMed]
4. Fabritius K, Balasesku M. Acute non-occupational intoxications with pesticides in Romania: a comparative study from 1988 to 1993. Toxicol Lett. 1996 Nov;88(1-3):211-4. [PubMed]
5. Gnyp L, Lewandowska-Stanek H. The analysis of organophosphates poisoning cases treated at the Centre for acute Poisoning in Lublin Provincial Hospital in 1994-1996. Przegl. Lek. 1997;54(10):734-6. [PubMed]
6. Kang EJ, Seok SJ, Lee KH, Gil HW, Yang JO, Lee EY, et al. Factors for determining survival in acute organophosphate poisoning. Korean J Intern Med. 2009 Dec; 24(4):362-7. [PubMed]
7. Ke X, Zhi S, Zheng D, Hong G, Zhao G, Li M, et al. [Analyses on relevant factors of the prognosis of patients with acute organophosphate poisoning.] [in Chinese] Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2015 Mar;33(3):186-9. [PubMed]
8. Laynez Bretones F, Martínez García L, Tortosa Fernández I, Lozano Padilla C, Montoya García M, Pimentel Asensio J. [Fatal food poisoning by parathion.] [in Spanish] Med Clin (Barc). 1997 Feb 15;108(6):224-5. [PubMed]
9. Lee JH, Lee YH, Park YH, Kim YH, Hong CK, Cho KW, et al. The difference in C-reactive protein value between initial and 24 hours follow-up (D-CRP) data as a predictor of mortality in organophosphate poisoned patients. Clin Toxicol (Phila). 2013 Jan;51(1):29-34. [PubMed]
10. Marinov P, Sabeva Y, Asparuhova М, [Analysis of the efficacy of pre-hospital first medical aid in cases of acute exogenous intoxications with organophosphorus pesticides from Varna region.] [in Bulgarian] Hygiene and Public Health. Sofia. 1999; XLII(2):8-10.
11. Sheu J. Wang D. Wu K. Determinants of lethality from suicidal pesticide poisoning in metropolitan HsinChu. Vet Hum Toxicol. 1998 Dec;40(6):332-6. [PubMed]
12. Singh D, Jit I, Tyagi S. Changing trends in acute poisoning in Chadigarth zone: a 25-year autopsy experience from a tertiary care hospital in northern India. Am J Forensic Med Pathol. 1999 Jun;20(2):203-10. [PubMed]
13. Sun IO, Yoon HJ, Lee KY. Prognostic factors in cholinesterase inhibitor poisoning. Med Sci Monit. 2015 Sep 28;21:2900-4. [PubMed]
14. Sungur M, Guven M. Intensive care management of organophosphate insecticide poisoning. Crit Care. 2001 Aug;5(4):211-5. [PubMed]
15. Senanayake N, de Silva HJ, Karalliedde L. A scale to assess severity in organophosphorus intoxication: POP scale. Hum Experim Toxicol. 1993 Jul;12(4):297-9. [PubMed]
16. Gazzi EN, Sorodoc V, Petris O, Tartau L, Dumitrescu G, Sorodoc L, et al. Butyrylcholinesterase activity-biomarker for predicting the outcome in acute cholinesterase inhibitor poisoning – a 30-year retrospective analysis. Rev Med Chir Soc Med Nat lasi. 2014 Oct-Dec;118(4):971-8. [PubMed]
17. Seyffart G. Poison index: The treatment of acute intoxication. Lengerich: Pabst Science Publishers; 1997. pp.110-7.
18. Chuang FR, Jang SW, Lin JL, Chern MS, Chen JB, Hsu KT. QTc prolongation indicates a poor prognosis in patients with organophosphate poisoning. Am. J Emerg Med. 1996 Sep;14(5):451-3. [PubMed]
19. Grmec S, Mally S, Klemen P. Glasgow Coma Scale score and QTc interval in the prognosis of organophosphate poisoning. Acad Emerg Med. 2004 Sep;11(9):925-30. [PubMed]
20. Lee DH, Jung KY, Choi YH, Cheon YJ. Body mass index as a prognostic factor in organophosphate-poisoned patients. Am J Emerg Med. 2014 Jul;32(7):693-6. [PubMed].

Received: 20 March 2017
Published online: 31 May 2017

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