Risk factors for the development of complications in Organophosphate and Carbamate poisoning

Organophosphate and carbamate (OPC) poisoning is a major concern in developing countries and is associated with increased risk of complications and mortality. The study aims to analyze the prevalence, clinical outcomes and identify the risk factors for complication development in patients with OPC poisoning. A total of 488 patients’ records with OPC poisoning admitted to Kasturba Hospital, Manipal from January 2013 and December 2017 were retrospectively analysed with respect to the complications developed. Demographics, clinical characteristics and risk factors were assessed to determine their association with the development of complications. Complications were developed in 37.9% of the patients with OPC poisoning. Aspiration pneumonia was predominant complication 13.9%. Sepsis (Odds ratio [OR]: 12.033), aspiration pneumonia (OR: 3.621), acute renal injury (OR: 20.032), cardiac arrest (OR: 139.921) and hypoxic ischemic encephalopathy (HIE) (OR: 13.508) were significantly associated with mortality (p 50 (OR: 3.851; CI: 2.309–6.423), prehospitalization period >24 hours (OR: 2.691; CI: 1.729–4.188) and pseudocholinesterase levels< 1400 IU/L (OR: 2.389; CI: 1.032–5.531) were predictive factors for the development of complications in OPC poisoning. OPC poisoning if unattended can lead to progressively severe adverse outcomes. Therefore, it is vital to rapidly initiate effective treatment and alert the healthcare professionals to carefully monitor the high-risk groups with older age, delayed admission and lower pseudocholinesterase levels that are susceptible to developing complications.