Correlates of organophosphorus compounds poisoning and critically ill patients’ outcomes at Cairo, Egypt

Background The literature review cited that, Organophosphorus compound poisoning (OPCP) stands as a significant health concern in numerous regions, especially in developing nations. It is an important indication for emergency admission in most hospitals throughout Egypt. Aim To explore the correlates, severity and clinical outcomes of OPCP among patients admitted to the poisoning center at Cairo University hospitals. Research questions To fulfill the aim of this study, four research questions were formulated. Design A descriptive exploratory research design was used. Setting The study was conducted in the ICU of clinical and environmental toxicology centers, which are affiliated to Cairo University Hospitals. Sample A purposive sample of 100 adult male and female patients were observed from the time of admission till discharge or death. Tools Three main tools were formulated. Results The findings of the current study denote that, more than two-thirds (71%) of the patients were from 18 to 30 years old, with female predominance (67%). More than one-third (38%) of them came from a popular area. The lag time was 2–4 h (76%) of patients. The most common risk factor for suicide was psychological stress in 61% of patients. Off-label OPC were the most commonly used compounds, followed by malathion and chlyrifos (72, 25, and 3%, respectively). About 51% of patients had a serum cholinesterase level less than normal on admission. Two-thirds of them (66%) had mild poisoning severity, while more than one-third (32%) had moderate poisoning severity, and only (2%) of them had severe poisoning severity. The most common presenting symptoms were vomiting, abdominal pain, excessive sweating, salivation, dyspnea, palpitation, lethargy and drowsy and pinpoint pupils (100,73, 91, 71, 34, 45, 65, and 87%), respectively. Finally, in relation to different patients’ outcomes, (38%) of them survived, while (60%) were left against medical advice, only (2%) of them died, and nearly half of them lasted for less than 2 days. Conclusion OPCP admissions represent a remarkable result all over 7 months of the study with female predominance especially younger adults. Psychological stress was the most common risk factors of OP self-poisoning. Solid off-label OPCs were the most common used compounds. Most mild OPC poisoning severity patients had a good prognosis especially when they came to the hospital as early as possible. The GIT symptoms were the most common presenting symptoms and the most common complications were electrolyte disturbances during hospitalization. Recommendations Increasing public awareness about organophosphorus poisoning and its long-term impact on health to prevent poisoning. Psychiatric consultation for patients admitted with acute organophosphorus poisoning before discharge. Replication of this study on a larger probability sample selected from different geographical areas in Egypt to obtain more generalizable data is recommended.