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World Journal of Emergency Medicine ›› 2021, Vol. 12 ›› Issue (1): 24-28.doi: 10.5847/wjem.j.1920-8642.2021.01.004

Special Issue: Poisoning

• Original Articles • Previous Articles     Next Articles

Clinical correlates of hypotension in patients with acute organophosphorus poisoning

Ning Dong1, Zhe-xi Lu2, Xing-liang Li1, Wei Li1, Li Pang1(), Ji-hong Xing1()   

  1. 1 Department of Emergency, the First Hospital of Jilin University, Changchun 130021, China
    2 School of Medicine, Pennsylvania State College of Medicine, Hershey 17033, USA
  • Received:2020-05-10 Accepted:2020-10-20 Online:2021-01-01 Published:2021-01-01
  • Contact: Li Pang,Ji-hong Xing E-mail:pangli211@163.com;jhxing1@qq.com

Abstract:

BACKGROUND: The aim of the present study is to describe the clinical correlates of hypotension and its associated outcomes in patients with acute organophosphorus poisoning (AOPP).

METHODS: In this retrospective cohort study, we analyzed data pertaining to 871 patients with AOPP who were treated at two hospitals. Data from hypotensive and non-hypotensive patients were compared to identify clinical correlates of hypotension. We also evaluated the association between clinical parameters (including hypotension) and in-hospital mortality.

RESULTS: The incidence of hypotension in AOPP patients was 16.4%. Hypotensive patients showed significantly higher in-hospital mortality (1.1% vs. 39.9%, P<0.001). Advanced age (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.08-1.44), history of diabetes (OR 2.65, 95% CI 1.14-5.96), and increased white blood cell count (OR 1.06, 95% CI 1.03-1.09), plasma cholinesterase (OR 0.91, 95% CI 0.84-0.94), plasma albumin (OR 0.88, 95% CI 0.85-0.92), serum amylase (OR 1.01, 95% CI 1.01-1.02), and blood pH (OR 0.64, 95% CI 0.54-0.75) were significantly associated with hypotension. After adjusting for potential confounders, hypotension was associated with increased in-hospital mortality (hazard ratio 8.77-37.06, depending on the controlled variables).

CONCLUSIONS: Hypotension is a common complication of AOPP and is associated with increased in-hospital mortality. Advanced age, history of diabetes, and changes in laboratory parameters were associated with hypotension in AOPP patients.

Key words: Acute organophosphate poisoning, Hypotension, Cholinesterase inhibitor, Cardiovascular complication, Shock