STUDY TO ASSESS PARADYENIA ORGANOPHOSPHOROUS POISONING SCALE AS A SEVERITY AND PROGNOSTIC MARKER IN PATIENTS PRESENTING TO EMERGENCY DEPARTMENT WITH HISTORY OF ORGANOPHOSPHOROUS COMPOUND CONSUMPTION

*Dr. Mary Priya Varghese, Dr. Akash B. J. and Dr. Basavaraj M. Patil

ABSTRACT

Background: Organophosphate compounds (OPC) cause most self-poisoning deaths in India due to their easy availability and lack of stringent laws. The use of these products for deliberate self-harm has increased proportionately with their use in agriculture. Organophosphorus (OP) insecticides are possibly one of the commonest causes of morbidity and mortality due to poisoning worldwide. Aim: To evaluate the prognostic value of the clinical parameters of the POP scale in predicting the severity of organophosphorous compound poisoning in terms of duration of hospital stay, mechanical ventilation and mortality. Methods and Materials: This was a prospective observational study of 60 patients with acute organophosphorus poisoning presenting to the emergency department of Raichur Institute Of Medical Sciences, Raichur. We performed the study over a one-year period from March 2023 to March 2024. All patients fulfilling the inclusion criteria were given initial treatment. We applied the POP scale to each patient at admission and graded their poisoning severity as, mild, moderate or severe. This scale assessed the patient's need for mechanical ventilation, ICU management and their final clinical outcome. Results: We enrolled a total of 60 patients in the study. Monocrotophos was the most commonly consumed OP compound, followed by chlorpyrifos. Most patients (47) were in the mild POP scale score range, 13 patients had moderate POP scale scores, and 3 of the patients had severe poisoning. 75% of patients (45) required ventilatory support, including 61.7% patients (29) with mild POP scale scores and 100% patients with moderate and severe scores. Among the 60 patients, 76% (46) improved, 14 patients expired. The mortality rate was 30.8% and 100% for patients with moderate and severe poisoning respectively. 68 % patients on ventilator support improved and 31 % died. All patients who did not require ventilator support survived. Conclusion: POP score at admission, correlated well with the need for ventilator support, length of stay in the ICU, complications, and mortality. It can thus be used for prognostication and risk stratification of patients with OP compound poisoning.

Keywords: Organophosphorous poisoning; POP score.