Abstract

Background: This study is aimed at evaluating the characteristics of plasma cholinesterase level in geriatric organophosphate (OP) poisoning patients and clinical courses associated with the plasma cholinesterase level.

Method: We conducted a retrospective study of 135 patients who had ingested organophosphate insecticides between Jan 2000 and Dec 2015. Patients were dichotomized into age ≥ 65 (geriatric group) and < 65 years (non-geriatric group). Clinical course and serial plasma cholinesterase level were investigated.

Results: Age was associated with higher incidence of hypotension and central nervous system depression (geriatric group vs. non-geriatric group: 38.6% vs. 21.1% [p = 0.032]; 37.8% vs. 19.1% [p = 0.019], respectively. The plasma cholinesterase level recovered more rapidly in the non-geriatric group than in the geriatric group (p = 0.022). Regarding outcomes, hospital survival rate was lower in the geriatric group than the non-geriatric group (73.3% vs. 91.1% respectively, p = 0.006).

Conclusions: In OP poisoning patients, even though the presenting symptoms and plasma cholinesterase level were similar, the incidences of shock and CNS depression during admission were higher in the geriatric group than in the non-geriatric group. Given these findings, physicians should beware of deterioration of geriatric OP poisoning patients even their initial presentation is mild.