유기인계 중독 환자에서 알코올이 사망률에 미치는 효과

Effect of Alcohol on Death Rate in Organophosphate Poisoned Patients

  • 민용훈 (한림대학교 성심병원 응급의학교실) ;
  • 박승민 (한림대학교 성심병원 응급의학교실) ;
  • 이귀자 (한림대학교 대학원 응급의학과) ;
  • 오영택 (한림대학교 성심병원 응급의학교실) ;
  • 안희철 (한림대학교 성심병원 응급의학교실) ;
  • 손유동 (한림대학교 성심병원 응급의학교실) ;
  • 안지윤 (한림대학교 성심병원 응급의학교실) ;
  • 이영환 (한림대학교 성심병원 응급의학교실) ;
  • 하상욱 (한림대학교 성심병원 응급의학교실) ;
  • 김유정 (한림대학교 성심병원 응급의학교실)
  • Min, Yong Hun (Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University) ;
  • Park, Seung Min (Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University) ;
  • Lee, Kui Ja (Emergency Medicine, Graduate School of Hallym University) ;
  • Oh, Young Taeck (Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University) ;
  • Ahn, Hee Cheol (Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University) ;
  • Sohn, You Dong (Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University) ;
  • Ahn, Ji Yun (Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University) ;
  • Lee, Young Hwan (Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University) ;
  • Ha, Sang Ook (Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University) ;
  • Kim, Yu Jung (Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University)
  • 투고 : 2015.05.11
  • 심사 : 2015.06.05
  • 발행 : 2015.06.30

초록

Purpose: Many patients who are acutely poisoned with organophosphorus pesticides have co-ingested alcohol. The purpose of this study was to identify the factors that influence mortality in organophosphate intoxication and the differences between alcohol coingested patients and non-coingested patients, looking at vital signs, length of admission, cholinesterase activity, complications, and mortality. Methods: All patients visiting one Emergency Department (ED) with organophosphate intoxication between January 2000 and December 2012 were reviewed retrospectively. The patients were divided into two groups, alcohol coingested group and non-coingested group. Results: During the study period, 136 patients (alcohol coingested group, 95 patients; non-coingested group, 41 patients) presented to the ED with organophosphate intoxication. Seventy-one alcohol coingested patients (74.1%) vs. 16 non-coingested patients (39.0%) received endotracheal intubation, with results of the analysis showing a clear distinction between the two groups (p=0.001). Twenty-three alcohol coingested patients (24.2%) vs. 1 non-coingested patient (2.4%) required inotropics, indicating a significant gap (p=0.002). Twenty-eight alcohol coingested patients (29.5%) vs. 2 non-coingested patients (4.9%) died, with results of the analysis showing a clear distinction between the two groups (p=0.002). Conclusion: In cases of organophosphate intoxication, alcohol coingested patients tended to receive endotracheal intubation, went into shock, developed central nervous system complications, and more died.

키워드

참고문헌

  1. Eddleston M, Buckley NA, Eyer P, Dawson AH. Management of acute organophosphorus pesticide poisoning. Lancet 2008;371:597-607. https://doi.org/10.1016/S0140-6736(07)61202-1
  2. Grmec S, Mally S, Klemen P. Glasgow Coma Scale score and QTc interval in the prognosis of organophosphate poisoning. Acad Emerg Med 2004;11:925-30. https://doi.org/10.1197/j.aem.2004.03.018
  3. Eddleston M, Gunnell D, von Meyer L, Eyer P. Relationship between blood alcohol concentration on admission and outcome in dimethoate organophosphorus self-poisoning.Br J Clin Pharmacol 2009;68:916-9. https://doi.org/10.1111/j.1365-2125.2009.03533.x
  4. Chun BJ Moon JM, Yoon HD, Heo T, Min YI. Clinical significance of immediate determination of plasma cholinesterase level in patients presenting with organophosphate ingestion at the time of hospitalization. J Korean Soc Emerg Med 2005;16:539-46.
  5. Lim SW, Park SM, Lee YH, Lee WW, Ahn JY, Sohn YD, et al. The Features and Prognoses in Organophosphate Intoxication according to Age. J Korean Geriatr Soc 2013;17:198-204. https://doi.org/10.4235/jkgs.2013.17.4.198
  6. Lee WJ, Youn CS, Kyong YY, Woo SH, Jeong SK, Choi SM, et al. Effect of Alcohol Ingestion on Clinical Features of Acute Drug Intoxicated Patients. J Kor Emerg Med 2009;20:115-21.
  7. Aghabiklooei A, Mostafazadeh B, Farzaneh E, Morteza A. Does organophosphate poisoning cause cardiac injury?. Pak J Pharm Sci 2013;26:1247-50.
  8. Han SC, Ko YH, Jung KW, Heo T, Min YI. Clinical investigation of pneumonia complicating organophosphate insecticide poisoning: is it really aspiration pneumonia?. J Korean Soc Emerg Med 2005;16:539-46.
  9. Ryu HK, Han HW, CHo HY, Kim IH, Lee IS, Lee KM. A clinical analysis of respiratory failure in patients with acute organophosphorus poisoning. Korean J Med 1993;45:507-15.
  10. Kang EJ, Seok SJ, Lee KH, Gil HW, Yang JO, Lee EY, et al. Factors for determining survival in acute organophosphate poisoning. Korean J Inter Med 2009;24:362-7. https://doi.org/10.3904/kjim.2009.24.4.362
  11. Jin WJ, Jeong TO, Jin YH, Lee JB. Clinico-toxicological characteristics of patients with acute organophosphate intoxication requiring mechanical ventilation. J Korean Soc Emerg Med 2004;15:554-60.
  12. Kim MJ, Heo KS, Kim HJ, Shin DK, Shin MJ, Sohn CH. Comparison of Prognosis in Organophosphate Intoxication by according to Atropine Dosage. Korean J Inter Med 1984;27:81-7.