Early onset pneumonia in patients with cholinesterase inhibitor poisoning

Chen Yu Wang, Chieh Liang Wu, Yu Tse Tsan, Jeng Yuan Hsu, Dong Zong Hung, Chih Hung Wang

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background and objective: Organophosphates and carbamates are potent cholinesterase inhibitors that are widely used as insecticides in agriculture. Pneumonia is a frequent complication of cholinesterase inhibitor poisoning (CIP) and a risk factor for death. The aim of this retrospective study was to assess the risk factors for pneumonia in patients with CIP. Methods: The medical records of 155 patients, who were treated for CIP in a 1300-bed medical centre in central Taiwan, from January 2002 to December 2004, were retrospectively analysed. Pneumonia was diagnosed by a new or persistent infiltrate on CXR, as well as clinical symptoms. Demographic data, comorbidities, acute respiratory failure and in-hospital mortality were also recorded. Results: Of the 155 patients, 31 (20%) died and 92 (59.4%) developed acute respiratory failure. Thirty-four patients (21.9%) were diagnosed with early onset pneumonia during hospitalization. Acute respiratory failure (OR 12.10, 95% CI: 2.55-57.45), underlying cardiovascular disease (OR 3.02, 95% CI: 1.02-8.91), undergoing gastric lavage at peripheral hospitals (OR 6.23, 95% CI: 1.52-25.98) and development of respiratory failure at the study centre after gastric lavage (OR 3.43, 95% CI: 1.17-10.0) were predictive factors for early onset pneumonia. Cardiopulmonary resuscitation (OR 23.58, 95% CI: 6.03-92.29), early onset pneumonia (OR 7.45, 95% CI: 2.02-27.5) and lower Glasgow coma score (OR 1.26, 95% CI: 1.08-1.48) were predictive factors for mortality. Conclusions: Pneumonia was a significant risk factor for death in patients with CIP. In addition to aggressive management of patients with CIP who develop respiratory failure, careful respiratory evaluation before and after gastric lavage would help to decrease the incidence of early onset pneumonia in patients with CIP.

Original languageEnglish
Pages (from-to)961-968
Number of pages8
JournalRespirology
Volume15
Issue number6
DOIs
Publication statusPublished - 2010 Aug 1

Fingerprint

Cholinesterase Inhibitors
Poisoning
Pneumonia
Respiratory Insufficiency
Gastric Lavage
Carbamates
Organophosphates
Cardiopulmonary Resuscitation
Coma
Insecticides
Hospital Mortality
Agriculture
Taiwan
Medical Records
Comorbidity
Hospitalization
Cardiovascular Diseases
Retrospective Studies
Demography
Mortality

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Wang, Chen Yu ; Wu, Chieh Liang ; Tsan, Yu Tse ; Hsu, Jeng Yuan ; Hung, Dong Zong ; Wang, Chih Hung. / Early onset pneumonia in patients with cholinesterase inhibitor poisoning. In: Respirology. 2010 ; Vol. 15, No. 6. pp. 961-968.
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title = "Early onset pneumonia in patients with cholinesterase inhibitor poisoning",
abstract = "Background and objective: Organophosphates and carbamates are potent cholinesterase inhibitors that are widely used as insecticides in agriculture. Pneumonia is a frequent complication of cholinesterase inhibitor poisoning (CIP) and a risk factor for death. The aim of this retrospective study was to assess the risk factors for pneumonia in patients with CIP. Methods: The medical records of 155 patients, who were treated for CIP in a 1300-bed medical centre in central Taiwan, from January 2002 to December 2004, were retrospectively analysed. Pneumonia was diagnosed by a new or persistent infiltrate on CXR, as well as clinical symptoms. Demographic data, comorbidities, acute respiratory failure and in-hospital mortality were also recorded. Results: Of the 155 patients, 31 (20{\%}) died and 92 (59.4{\%}) developed acute respiratory failure. Thirty-four patients (21.9{\%}) were diagnosed with early onset pneumonia during hospitalization. Acute respiratory failure (OR 12.10, 95{\%} CI: 2.55-57.45), underlying cardiovascular disease (OR 3.02, 95{\%} CI: 1.02-8.91), undergoing gastric lavage at peripheral hospitals (OR 6.23, 95{\%} CI: 1.52-25.98) and development of respiratory failure at the study centre after gastric lavage (OR 3.43, 95{\%} CI: 1.17-10.0) were predictive factors for early onset pneumonia. Cardiopulmonary resuscitation (OR 23.58, 95{\%} CI: 6.03-92.29), early onset pneumonia (OR 7.45, 95{\%} CI: 2.02-27.5) and lower Glasgow coma score (OR 1.26, 95{\%} CI: 1.08-1.48) were predictive factors for mortality. Conclusions: Pneumonia was a significant risk factor for death in patients with CIP. In addition to aggressive management of patients with CIP who develop respiratory failure, careful respiratory evaluation before and after gastric lavage would help to decrease the incidence of early onset pneumonia in patients with CIP.",
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Early onset pneumonia in patients with cholinesterase inhibitor poisoning. / Wang, Chen Yu; Wu, Chieh Liang; Tsan, Yu Tse; Hsu, Jeng Yuan; Hung, Dong Zong; Wang, Chih Hung.

In: Respirology, Vol. 15, No. 6, 01.08.2010, p. 961-968.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Early onset pneumonia in patients with cholinesterase inhibitor poisoning

AU - Wang, Chen Yu

AU - Wu, Chieh Liang

AU - Tsan, Yu Tse

AU - Hsu, Jeng Yuan

AU - Hung, Dong Zong

AU - Wang, Chih Hung

PY - 2010/8/1

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N2 - Background and objective: Organophosphates and carbamates are potent cholinesterase inhibitors that are widely used as insecticides in agriculture. Pneumonia is a frequent complication of cholinesterase inhibitor poisoning (CIP) and a risk factor for death. The aim of this retrospective study was to assess the risk factors for pneumonia in patients with CIP. Methods: The medical records of 155 patients, who were treated for CIP in a 1300-bed medical centre in central Taiwan, from January 2002 to December 2004, were retrospectively analysed. Pneumonia was diagnosed by a new or persistent infiltrate on CXR, as well as clinical symptoms. Demographic data, comorbidities, acute respiratory failure and in-hospital mortality were also recorded. Results: Of the 155 patients, 31 (20%) died and 92 (59.4%) developed acute respiratory failure. Thirty-four patients (21.9%) were diagnosed with early onset pneumonia during hospitalization. Acute respiratory failure (OR 12.10, 95% CI: 2.55-57.45), underlying cardiovascular disease (OR 3.02, 95% CI: 1.02-8.91), undergoing gastric lavage at peripheral hospitals (OR 6.23, 95% CI: 1.52-25.98) and development of respiratory failure at the study centre after gastric lavage (OR 3.43, 95% CI: 1.17-10.0) were predictive factors for early onset pneumonia. Cardiopulmonary resuscitation (OR 23.58, 95% CI: 6.03-92.29), early onset pneumonia (OR 7.45, 95% CI: 2.02-27.5) and lower Glasgow coma score (OR 1.26, 95% CI: 1.08-1.48) were predictive factors for mortality. Conclusions: Pneumonia was a significant risk factor for death in patients with CIP. In addition to aggressive management of patients with CIP who develop respiratory failure, careful respiratory evaluation before and after gastric lavage would help to decrease the incidence of early onset pneumonia in patients with CIP.

AB - Background and objective: Organophosphates and carbamates are potent cholinesterase inhibitors that are widely used as insecticides in agriculture. Pneumonia is a frequent complication of cholinesterase inhibitor poisoning (CIP) and a risk factor for death. The aim of this retrospective study was to assess the risk factors for pneumonia in patients with CIP. Methods: The medical records of 155 patients, who were treated for CIP in a 1300-bed medical centre in central Taiwan, from January 2002 to December 2004, were retrospectively analysed. Pneumonia was diagnosed by a new or persistent infiltrate on CXR, as well as clinical symptoms. Demographic data, comorbidities, acute respiratory failure and in-hospital mortality were also recorded. Results: Of the 155 patients, 31 (20%) died and 92 (59.4%) developed acute respiratory failure. Thirty-four patients (21.9%) were diagnosed with early onset pneumonia during hospitalization. Acute respiratory failure (OR 12.10, 95% CI: 2.55-57.45), underlying cardiovascular disease (OR 3.02, 95% CI: 1.02-8.91), undergoing gastric lavage at peripheral hospitals (OR 6.23, 95% CI: 1.52-25.98) and development of respiratory failure at the study centre after gastric lavage (OR 3.43, 95% CI: 1.17-10.0) were predictive factors for early onset pneumonia. Cardiopulmonary resuscitation (OR 23.58, 95% CI: 6.03-92.29), early onset pneumonia (OR 7.45, 95% CI: 2.02-27.5) and lower Glasgow coma score (OR 1.26, 95% CI: 1.08-1.48) were predictive factors for mortality. Conclusions: Pneumonia was a significant risk factor for death in patients with CIP. In addition to aggressive management of patients with CIP who develop respiratory failure, careful respiratory evaluation before and after gastric lavage would help to decrease the incidence of early onset pneumonia in patients with CIP.

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