Limits...
Acute Anticholinesterase Pesticide Poisoning Caused a Long-Term Mortality Increase: A Nationwide Population-Based Cohort Study.

Huang HS, Hsu CC, Weng SF, Lin HJ, Wang JJ, Su SB, Huang CC, Guo HR - Medicine (Baltimore) (2015)

Bottom Line: 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.

View Article: PubMed Central - PubMed

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).

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.

Show MeSH

Related in: MedlinePlus

Survival rate for patients with anticholinesterase pesticide poisoning (ACPP) cohort and comparison cohort during the follow-up.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4554117&req=5

Figure 2: Survival rate for patients with anticholinesterase pesticide poisoning (ACPP) cohort and comparison cohort during the follow-up.

Mentions: Overall mortality was 5.2% during the follow-up: 11.5% in the ACPP cohort and 4.9% in the comparison cohort (Table 2). The ACPP cohort had a significantly higher risk for death than did the comparison cohort (IRR: 2.5; 95% confidence interval [CI]: 2.0–3.1). The highest risk for death was in the first month after ACPP (IRR: 92.7; 95% CI: 45.0–191.0) and was still higher between 1 and 6 months (Table 2); however, there was no significant difference after 6 months. Kaplan–Meier survival analyses and log-rank tests also showed that the ACPP cohort had a significantly higher mortality risk than did comparison cohort during the follow-up period (Figure 2).


Acute Anticholinesterase Pesticide Poisoning Caused a Long-Term Mortality Increase: A Nationwide Population-Based Cohort Study.

Huang HS, Hsu CC, Weng SF, Lin HJ, Wang JJ, Su SB, Huang CC, Guo HR - Medicine (Baltimore) (2015)

Survival rate for patients with anticholinesterase pesticide poisoning (ACPP) cohort and comparison cohort during the follow-up.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554117&req=5

Figure 2: Survival rate for patients with anticholinesterase pesticide poisoning (ACPP) cohort and comparison cohort during the follow-up.
Mentions: Overall mortality was 5.2% during the follow-up: 11.5% in the ACPP cohort and 4.9% in the comparison cohort (Table 2). The ACPP cohort had a significantly higher risk for death than did the comparison cohort (IRR: 2.5; 95% confidence interval [CI]: 2.0–3.1). The highest risk for death was in the first month after ACPP (IRR: 92.7; 95% CI: 45.0–191.0) and was still higher between 1 and 6 months (Table 2); however, there was no significant difference after 6 months. Kaplan–Meier survival analyses and log-rank tests also showed that the ACPP cohort had a significantly higher mortality risk than did comparison cohort during the follow-up period (Figure 2).

Bottom Line: 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.

View Article: PubMed Central - PubMed

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).

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.

Show MeSH
Related in: MedlinePlus