Prediction of Different Outcomes in Patients of Acute Chlorpyrifos Poisoning

Sobeeh, Fatma G.; Khalifa, Heba K.; Abdel Dayem, Yara Bahloul

doi:10.21608/ajfm.2024.294294.1137

Prediction of Different Outcomes in Patients of Acute Chlorpyrifos Poisoning

Document Type : Original Article

Authors

forensic medicine and clinical toxicology, faculty of medicine, tanta university

10.21608/ajfm.2024.294294.1137

Abstract

Background: Organophosphorus compounds (OPCs) such as chlorpyrifos (CPF) are powerful cholinesterase inhibitorsChlorpyrifos is a broad-spectrum chlorinated organophosphate first introduced into the markets in 1965. Objectives: This study aims to evaluate the baseline characteristics, clinical manifestations, and prognostic factors of patients with acute chlorpyrifos (CPF) intoxication, differentiating between those with good and poor prognoses based on the need for mechanical ventilation, ICU admission, and mortality
Methods: We conducted a retrospective analysis of 31 patients with acute CPF intoxication. Patients were stratified into good prognosis (n=21, 67.8%) and poor prognosis (n=10, 32.2%) groups. Data on demographics, exposure details, clinical symptoms, laboratory results, and treatment outcomes were collected and analyzed.
Results: The median age of patients was 28 years, with a slight female predominance (51.6%). Clinically, the most common symptoms were vomiting (87.1%), diarrhea (83.9%), chest crepitation (80.6%), hypotonia (58.1%), miosis (54.8%). Poor prognosis was significantly associated with hypotonia (p=0.013), fasciculations (p=0.029), hypotension (p=0.001), bradycardia (p<0.001), and lower Glasgow Coma Scale (GCS) scores (p<0.001). The median GCS was 6, with a stark contrast between good prognosis (median GCS of 15) and poor prognosis groups (median GCS of 4). Laboratory findings showed lower serum bicarbonate levels (p=0.030) and higher random blood sugar levels (p=0.041) in the poor prognosis group. Treatment analysis revealed that poor prognosis patients required significantly more atropine and oximes (p=0.002 each).
Conclusion: GCS and pulse were significant predictors of poor prognosis in patients with acute CPF intoxication. Early identification and aggressive management of these predictors could potentially improve patient outcomes.

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