Glycemic status as a predictor for the outcomes in patients with acute organophosphorus pesticides poisoning

Sagah, Ghada Attia; Elhawary, Amira Elsayed

doi:10.21608/ejfsat.2021.44206.1169

Glycemic status as a predictor for the outcomes in patients with acute organophosphorus pesticides poisoning

Document Type : Original Article

Authors

¹ Forensic Medicine and Clinical Toxicology Department,Faculty of Medicine, Tanta University,Tanta,Egypt

² Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

10.21608/ejfsat.2021.44206.1169

Abstract

Acute organophosphate (OP) toxicity is a major health problem in different populations. Nearly three million cases are affected annually all over the world. The most common clinical presentations include muscarinic, nicotinic and central nervous system manifestations resulting from cholinergic overload. Nevertheless, endocrine toxicity and affection of glucose homeostasis are reported. The current study aimed to study random blood sugar (RBS) as a simple, inexpensive tool to predict mortality and major outcome events in acute organophosphate poisonings. Ninety adult patients with acute organophosphate poisoning were included in the study. Patients already known to be diabetic before exposure and those with mixed intoxication were excluded. RBS was done to all included patients on admission before receiving any medications. Patients were categorized into euglycemics (62.2%), hyperglycemic (28.9%) and hypoglycemics (8.9%). The severity of organophosphorus poisoning symptoms and signs was graded into; Mild (32.2%), Moderate (38.9%) and Severe (28.9%) grades with a statistically significant association between RBS and poisoning severity at the time of admission. In addition, RBS showed a statistically significant association with each of serum cholinesterase levels, the delay time before hospital admission, the need for intubation, mechanical ventilation and death. Meanwhile, RBS had no statistically significant association with either doses of atropine & toxogonine nor the duration of hospital stay.

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