Abstract
INTRODUCTION: Organophosphate poisoning (OPP) is a major health-care burden in South Africa. Recently, we have observed that patients admitted to our Intensive Care Unit (ICU) with OPP have followed a more complicated course in comparison to previous years. OBJECTIVES: To describe the differences in the clinical course and costs of patients with OPP between two time periods, namely 2012 and 2017. METHODS: Retrospective comparison of patients admitted to the Intensive Care Unit (ICU) of Chris Hani Baragwanath Academic Hospital between January 2012 to December 2012 and January 2017 to December 2017. RESULTS: Forty-one patients were found in the database. Patients from our 2017 cohort showed a significantly longer total median (IQR) length of stay 8 (4-17) days vs. 2 (2-3) days, p = 0.000, duration of antidote therapy 5 (3-10) days vs. 2 (2-3) days, p = 0.004 and duration of ventilation 4 (2-11) days vs 1 (1-2) day, p = 0.003. Patients presenting in 2017 were more likely to be admitted to ICU, odds ratio 5.6 (CI 1.2-26). There was a 31- fold increase in ICU costs between 2012 and 2017. CONCLUSION: Based on our experience, the clinical course of OPP requiring ICU admission has evolved into a condition with a longer length of stay, duration of antidote therapy, ventilatory support, increased risk of complications and additional costs.