Heart Rate-corrected QT Interval Helps Predict Mortality After Intentional Organophosphate Poisoning

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2012 May 11

PMID 22574184

Citations 19

Authors

Shou-Hsuan Liu

Ja-Liang Lin

Cheng-Hao Weng

Huang-Yu Yang

Ching-Wei Hsu

Kuan-Hsing Chen

Wen-Hung Huang

Tzung-Hai Yen

Affiliations

Soon will be listed here.

Abstract

Introduction: In this study, we investigated the outcomes for patients with intentional organophosphate poisoning. Previous reports indicate that in contrast to normal heart rate-corrected QT intervals (QTc), QTc prolongation might be indicative of a poor prognosis for patients exposed to organophosphates.

Methods: We analyzed the records of 118 patients who were referred to Chang Gung Memorial Hospital for management of organophosphate poisoning between 2000 and 2011. Patients were grouped according to their initial QTc interval, i.e., normal (<0.44 s) or prolonged (>0.44 s). Demographic, clinical, laboratory, and mortality data were obtained for analysis.

Results: The incidence of hypotension in patients with prolonged QTc intervals was higher than that in the patients with normal QTc intervals (P = 0.019). By the end of the study, 18 of 118 (15.2%) patients had died, including 3 of 75 (4.0%) patients with normal QTc intervals and 15 of 43 (34.9%) patients with prolonged QTc intervals. Using multivariate-Cox-regression analysis, we found that hypotension (OR = 10.930, 95% CI = 2.961-40.345, P = 0.000), respiratory failure (OR = 4.867, 95% CI = 1.062-22.301, P = 0.042), coma (OR = 3.482, 95% CI = 1.184-10.238, P = 0.023), and QTc prolongation (OR = 7.459, 95% CI = 2.053-27.099, P = 0.002) were significant risk factors for mortality. Furthermore, it was revealed that non-survivors not only had longer QTc interval (503.00±41.56 versus 432.71±51.21 ms, P = 0.002), but also suffered higher incidences of hypotension (83.3 versus 12.0%, P = 0.000), shortness of breath (64 versus 94.4%, P = 0.010), bronchorrhea (55 versus 94.4%, P = 0.002), bronchospasm (50.0 versus 94.4%, P = 0.000), respiratory failure (94.4 versus 43.0%, P = 0.000) and coma (66.7 versus 11.0%, P = 0.000) than survivors. Finally, Kaplan-Meier analysis demonstrated that cumulative mortality was higher among patients with prolonged QTc intervals than among those with normal QTc intervals (Log-rank test, Chi-square test = 20.36, P<0.001).

Conclusions: QTc interval helps predict mortality after intentional organophosphate poisoning.

Citing Articles

Early vs. delayed QTc prolongation in acute poisoning: A prognostic accuracy study-A case series.

Shahpar A, Mirafzal A, Movahedi M, Nezhad N PLoS One. 2024; 19(9):e0309940.

PMID: 39255304 PMC: 11386474. DOI: 10.1371/journal.pone.0309940.

Human Poisoning with Chlorpyrifos and Cypermethrin Pesticide Mixture: Assessment of Clinical Outcome of Cases Admitted in a Tertiary Care Hospital in Taiwan.

Wu Y, Chang S, Chen H, Tsai K, Lee W, Wang I Int J Gen Med. 2023; 16:4795-4804.

PMID: 37908758 PMC: 10614644. DOI: 10.2147/IJGM.S432861.

Clinical characteristics and early prediction of mortality risk in patients with acute organophosphate poisoning-induced shock.

Xu B, Zeng W, Chen F, Lin G, Wang M, Ding J Front Med (Lausanne). 2023; 9:990934.

PMID: 36714143 PMC: 9874994. DOI: 10.3389/fmed.2022.990934.

Outcomes of elderly patients with organophosphate intoxication.

Yu J, Hou Y, Fu J, Wang I, Chan M, Chen C Sci Rep. 2021; 11(1):11615.

PMID: 34079035 PMC: 8172550. DOI: 10.1038/s41598-021-91230-2.

Hemodynamic and electromechanical effects of paraquat in rat heart.

Lin C, Hsu K, Shih C, Chang G PLoS One. 2021; 16(4):e0234591.

PMID: 33793552 PMC: 8016255. DOI: 10.1371/journal.pone.0234591.

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