What is the prognosis for organophosphate (OP) toxicity?

Updated: Dec 31, 2020
  • Author: Kenneth D Katz, MD, FAAEM, ABMT; Chief Editor: Sage W Wiener, MD  more...
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Answer

In a study of acute organophosphate insecticide poisoning in which 12 of the 71 patients died, multivariate logistic regression analysis identified the following as independent factors indicating a poor prognosis [30] :

  • High 6-hour post-admission blood lactate levels
  • Low blood pH
  • Low post-admission 6-hour lactate clearance rates

Worldwide mortality studies report mortality rates from 3-25%. [8]  The compounds most frequently involved include malathion, dichlorvos, trichlorfon, and fenitrothion/malathion.

Mortality rates depend on the type of compound used, amount ingested, general health of the patient, delay in discovery and transport, insufficient respiratory management, delay in intubation, and failure in weaning off ventilatory support.

Complications include severe bronchorrhea, seizures, weakness, and neuropathy. Respiratory failure is the most common cause of death.


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