Acute anticholinesterase pesticide poisoning caused a long-term mortality increase: A nationwide population-based cohort study

Hung Sheng Huang, Chien Chin Hsu, Shih Feng Weng, Hung Jung Lin, Jhi Joung Wang, Shih Bin Su, Chien Cheng Huang, How Ran Guo

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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 followup after acute treatment, comorbidity control and socioeconomic assistance are needed for patients with ACPP.

Original languageEnglish
Article numbere1222
JournalMedicine (United States)
Volume94
Issue number30
DOIs
Publication statusPublished - 2015 Jul 1

Fingerprint

Cholinesterase Inhibitors
Pesticides
Poisoning
Cohort Studies
Mortality
Population
Comorbidity
Incidence
Confidence Intervals
Organophosphate Poisoning
Carbamates
National Health Programs
Taiwan
Mental Disorders
Coronary Artery Disease
Diabetes Mellitus
Stroke
Databases
Hypertension
Research

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Huang, Hung Sheng ; Hsu, Chien Chin ; Weng, Shih Feng ; Lin, Hung Jung ; Wang, Jhi Joung ; Su, Shih Bin ; Huang, Chien Cheng ; Guo, How Ran. / Acute anticholinesterase pesticide poisoning caused a long-term mortality increase : A nationwide population-based cohort study. In: Medicine (United States). 2015 ; Vol. 94, No. 30.
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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 followup after acute treatment, comorbidity control and socioeconomic assistance are needed for patients with ACPP.",
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Acute anticholinesterase pesticide poisoning caused a long-term mortality increase : A nationwide population-based cohort study. / Huang, Hung Sheng; Hsu, Chien Chin; Weng, Shih Feng; Lin, Hung Jung; Wang, Jhi Joung; Su, Shih Bin; Huang, Chien Cheng; Guo, How Ran.

In: Medicine (United States), Vol. 94, No. 30, e1222, 01.07.2015.

Research output: Contribution to journalArticle

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T1 - Acute anticholinesterase pesticide poisoning caused a long-term mortality increase

T2 - A nationwide population-based cohort study

AU - Huang, Hung Sheng

AU - Hsu, Chien Chin

AU - Weng, Shih Feng

AU - Lin, Hung Jung

AU - Wang, Jhi Joung

AU - Su, Shih Bin

AU - Huang, Chien Cheng

AU - Guo, How Ran

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AB - 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 followup after acute treatment, comorbidity control and socioeconomic assistance are needed for patients with ACPP.

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