Organophosphate poisoning in Perth, Western Australia, 1987-1996

This study aimed to review the presentation and management of patients with organophosphate poisoning admitted to the four tertiary teaching hospitals in Perth, Western Australia, over a 10-year period. The case notes of all 69 patients admitted with a discharge diagnosis of organophosphate poisoning were reviewed. Twenty-two of 25 patients (88%) attempting suicide were admitted to Intensive Care Units (ICUs), with a mean stay of 7 days (range 1-25 days). All but one were men, and two died. The 44 patients with accidental exposure were mainly children and had a mean stay of 2 days, with only seven going to the ICU. All survived. Complications overall included respiratory failure, convulsions, and aspiration pneumonia. Intubation and ventilation were required in 11 patients (16%), with a mean ventilation duration of 6 days (range 1-25 days). We conclude that deliberate ingestion of organophosphates is considerably more toxic than accidental exposure. Men aged 30-50 years were the most likely to attempt suicide with these agents and had prolonged ICU admissions with significant complications and mortality.