TY  - JOUR
PY  - 2023//
TI  - Acute organophosphorus toxicity in a regional hospital in Johannesburg, South Africa: a retrospective chart review
JO  - African journal of emergency medicine
A1  - Khonje, Vanessa
A1  - Hart, Jedd
A1  - Venter, Jakus
A1  - Deonarain, Saisha
A1  - Grossberg, Saul
SP  - 104
EP  - 108
VL  - 13
IS  - 2
N2  - INTRODUCTION: Intentional and accidental organophosphorus exposures pose a significant healthcare-related burden on South African communities. This study will review the demographics, characteristics and clinical course of patients presenting with features of acute organophosphorus toxicity to a regional Emergency Centre in Johannesburg, South Africa. <br><br>METHODS: This was a retrospective chart review of all patients treated for possible acute organophosphorus toxicity from January 2020 to August 2021. <br><br>RESULTS: A total of 205 patients were identified of which 134 patients were included in the study. The median age was 26 years with a male predominance (male= 56%, female=44%). 109 patients (81.3%) survived, 18 patients (13.4%) demised and the outcome of 7 patients (5.2%) was unknown. The median hospital length of stay was 8 days, (IQR= 5-13 days), and the longest hospital stay was 37 days in ICU. Atropinisation dose was significantly higher for intubated patients (median=140.0mg; IQR=90mg-219.5mg) compared to patients who were not intubated (median=60mg; IQR=20.5mg-120mg, p < 0.05). The length of stay was significantly higher for intubated patients (median=11 days; IQR=7-15 days) compared to patients who were not intubated (median=5 days; IQR=3-8 days, p < 0.00). There was a moderate positive correlation between atropinisation dose and length of stay (Correlation coefficient = 0.37, p < 0.00). There was a moderate negative correlation between atropinisation dose and cholinesterase level (Correlation coefficient= - 0.39, p < 0.00). Of those reported to have adverse effects 78.6%, were related to atropine toxicity. <br><br>CONCLUSION: Our study shows a high mortality rate secondary to organophosphorus toxicity. Significant exposures and thus higher doses of atropine were associated with increased length of stay and need for intubation. We found a high incidence of atropine-related adverse effects. More studies are needed to further establish the balance between the therapeutic and adverse effects of high-dose atropine as a treatment modality for organophosphorus toxicity.<p />  <p>Language: en</p>
LA  - en
SN  - 2211-419X
UR  - http://dx.doi.org/10.1016/j.afjem.2023.04.002
ID  - ref1
ER  -