ABSTRACT
Objective: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate [OP] poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature
Methods: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department [ED] or intensive care unit [ICU] of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated. All the data were obtained from electronic and manual patient files. A total of 80 patients were included in the study
Results: The mean age of the study patients was 32.4 +/- 15.0 [13-94]. Forty-nine [61.2%] patients were female. Twenty-two [27.5%] patients were seriously poisoned and needed mechanical ventilation [MV] support. Low pseudocholinesterase [PChE], high creatinine [Cr], low Glasgow Coma Scale [GCS] scores and long hospitalization durations were all found to be poor prognostics in MV patients. Low PChE and high Cr levels were found to be independent predictors of the hospitalization duration and high Cr was found to be an independent predictor of the intubation duration of MV patients in regression analyses. Ten [45.5%] of the MV patients were unresponsive to medical treatment and Therapeutic plasma exchange [TPE] was performed. Seven patients were discharged healthy. Three patients with low PChE levels and comorbidities died
Conclusions: Prolongation of respiratory depression necessitating MV support, comorbidities, long hospital stay, elevated creatinine, low GCS scores and low PcHE levels without regeneration in the first 48 hours of admission are all found to be poor prognostic factors for organophosphate [OP] poisoning
ABSTRACT
Background: In literature, electrocardiographic (ECG) changes and the increase in the levels of the natriuretic peptide are shown to occur in patients having acute ischemic stroke. We aimed to investigate the association between ECG alterations and NT pro B-type natriuretic peptide (NT-proBNP) values in patients having acute ischemic stroke with no known cardiac pathology. Methods: The patients who admitted to the emergency service with acute ischemic stroke were enrolled in the study. Their ECGs were recorded and serum samples were obtained as soon as they arrived into the emergency service. The plasma NT-proBNP levels were measured by electrochemiluminescence method. Maximum QT interval, QT dispersion (QTd), corrected QT and corrected QTd (cQT and cQTd) was calculated, for each ECG. The patients were evaluated according to the Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS). Results: A total of 50 consecutive patients were evaluated. QT intervals for 4 patients (8%) and cQT intervals for 29 patients (58%) were above 440 ms and 11 patients (22%) had QTd values above 50ms and 17 (34%) had cQTd values above 50 ms. The NTproBNP levels had a negative correlation with the GCS (p=0.001, r= -0.461) and a positive correlation with the NIHSS, cQT, QTd and cQTd (p=0.001, r=0.444, p=0.000, r=0.494, p=0.016, r=0.338 p=0.011, r=0.355, respectively). Conclusions: The NT-proBNP levels in the ischemic stroke patients with no known cardiac pathology were markedly increased, and this increase was found to be associated with the GCS, NIHSS, cQT, QTd and the cQTd interval.