Serum Electrolyte Disturbances among Acute Organophosphorus Poisoning Patients and its Relationship with Severity and Hospital Outcome in a Tertiary Level Hospital of Bangladesh
Abstract
Background: Organophosphorus Compounds (OPC) are used as insecticides, become a popular method of selfharm and clinicians frequently encounter it at different level of hospitals in Bangladesh. This study was done to analyze the role of electrolyte disturbances in the severity and hospital outcome of OPC poisoning patients. Methods: This longitudinal descriptive study was conducted at the department of Medicine, Rajshahi medical college, from July 2021 to December 2022, following ethical approval. Total 180 patients who had the history of acute organophosphorus compound ingestion within twenty-four hours of admission were included after taking informed written consent. A detailed history and thorough clinical examination were carried out in each patient. Serum electrolytes were measured for all patients. Data were recorded in structured pro form and analyzed by SPSS 24. Result: Mean age of all study subjects was 26.4±7.38 SD (years) with male predominance (61.1%). Bradycardia, tachypnoea, constricted pupil, signs of fasciculation, seizure and impaired or no response to verbal command were observed in 44.5%, 42.3%, 40.6%, 38.8%, 6.1% and 21.2% cases, respectively. According to POP scale, maximum (54.4%) patients had mild poisoning, while 35.6% had moderate poisoning and only 10% had severe poisoning. The frequency of hyponatremia, hypokalemia and hypochloremia were 6.1%, 11.7% and 5%, respectively. Ventilator support was required in 14.4% cases and in-hospital mortality rate was 3.9%. Hypokalemia, hyponatremia and combination of both were significantly associated with severity and inhospital mortality and ventilator requirement was associated with hypokalemia. Conclusion: Hypokalemia was associated with increased severity and bad hospital outcome of the acute OPC poisoning patients. However, further larger studies are recommended.