Study of electrocardiographic changes in organophosphorus poisoning

 

 

Abstract              Background: Organophosphorus compound poisoning is a global problem and is most common medico toxic emergency in India and it is associated with high rate of mortality, if not diagnosed early and treated adequately. We studied clinical profile and electrocardiographic changes in patients with organophophorus compound poisoning. Methodology: We studied 50 patients after applying inclusion and exclusion criteriia of organophosphorus compound poisoning admitted within 12 hours of consumption. Clinical profile, electrocardiographic changes were analyzed on outcome basis. Results: In this study, most vulnerable age group was between 21-30 years (46%) where 36% male and 14% in female and male to female ratio is 2.26:1. Majority of patient belongs to agriculture occupation(58%). In all the patients route of intake was oral(34%), commonest symptom found was sweating(42%) and commonest sign was smell of poison (100%). Type of organophosphate was identified in 74% and unidentified in 26% patients. Monocrotophos(38%) was most common compound among identified group. Majority of patients(94%) were hospitalized within 2-4 hrs of organophosphate compound consumption and total hospital stay was 6-10 days in 58% patients. Electrocardiographic changes were detected in 84% patient, most common electrocardiographic change was sinus tachycardia(32%), QTc prolongation (28%), ST-T wave changes (22%), sinus bradycadia (22%), conduction defects(8%). Morality rate in present study is 12%, mortality rate among patient with prolonged QTc interval was 28.57% and was statistically significant when compared with morality of 5.55% in those with normal QTc interval. Conclusions: Estimation of electrocardiographic changed will be useful parameter in assessing prognosis of organophosphate compound poisoning patients. ECG changes like QTc prolongation are potentially dangerous and indicate the necessity of continuous cardiac monitoring.

Key Words: Clinical profile; electrocardiography;