Citation

Huang HS, Hsu CC, Weng SF, Lin HJ, Wang JJ, Su SB, Huang CC, Guo HR. Medicine (Baltimore) 2015; 94(30): e1222.

Affiliation

From the Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan (H-SH, C-C Hsu, H-JL, C-C Huang); Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan (H-SH, S-BS, C-C Huang); Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan (C-C Hsu, H-JL); Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan (S-FW, J-JW); Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan (S-FW); Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan (H-JL); Department of Leisure, Recreation, and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan (S-BS); Department of Medical Research, Chi Mei Medical Center, Liouying, Tainan, Taiwan (S-BS); Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C-C Huang, H-RG); Department of Child Care and Education, Southern Taiwan University of Science and Technology, Tainan, Taiwan (C-C Huang); Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan (C-C Huang); Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan (H-RG).

Copyright

(Copyright © 2015, Lippincott Williams and Wilkins)

DOI

10.1097/MD.0000000000001222

PMID

26222853

Abstract

Acute anticholinesterase pesticide (organophosphate and carbamate) poisoning (ACPP) often produces severe complications, and sometimes death. We investigated the long-term mortality of patients with ACPP because it is not sufficiently understood. In this retrospective nationwide population-based cohort study, 818 patients with ACPP and 16,360 healthy comparisons from 1999 to 2010 were selected from Taiwan's National Health Insurance Research Database. They were followed until 2011. Ninety-four (11.5%) ACPP patients and 793 (4.9%) comparisons died (P < 0.01) during follow-up. The incidence rate ratios (IRRs) of death were 2.5 times higher in ACPP patients than in comparisons (P < 0.01). The risk of death was particularly high in the first month after ACPP (IRR: 92.7; 95% confidence interval [CI]: 45.0-191.0) and still high for ∼6 months (IRR: 3.8; 95% CI: 1.9-7.4). After adjusting for age, gender, selected comorbidities, geographic area, and monthly income, the hazard ratio of death for ACPP patients was still 2.4 times higher than for comparisons. Older age (≥35 years), male gender, diabetes mellitus, coronary artery disease, hypertension, stroke, mental disorder, and lower monthly income also predicted death. ACPP significantly increased long-term mortality. In addition to early follow-up after acute treatment, comorbidity control and socioeconomic assistance are needed for patients with ACPP.

Language: en