Human Poisoning with Chlorpyrifos and Cypermethrin Pesticide Mixture: Assessment of Clinical Outcome of Cases Admitted in a Tertiary Care Hospital in Taiwan

Figures & data

Table 1 Published Literatures on the Medical Complications of Chlorpyrifos and Cypermethrin Poisoning

Year	Study	Sample Size	Pesticide	Acute Respiratory Failure Rate, %	Mortality Rate, %
Current study	Wu et al	121	Chlorpyrifos, cypermethrin, chlorpyrifos and cypermethrin	48.8 (chlorpyrifos), 11.1 (cypermethrin), 58.3 (chlorpyrifos and cypermethrin)	17.1 (chlorpyrifos), 3.7 (cypermethrin), 16.7 (Chlorpyrifos and cypermethrin)
2021	Jacob et al^Citation13	59	Cypermethrin	5.6	0
2020	Liu et al^Citation1	40	Chlorpyrifos	42.5	15.0
2014	Iyyadurai et al^Citation12	84	Chlorpyrifos, cypermethrin, chlorpyrifos and cypermethrin	42.3 (chlorpyrifos), 15.7 (cypermethrin), 53.1 (chlorpyrifos and cypermethrin)	0 (chlorpyrifos), 0 (cypermethrin), 13 (chlorpyrifos and cypermethrin)
2012	Liu et al^Citation11	118	Chlorpyrifos	50.8	15.3
2010	Dawson et al^Citation10	1376	Chlorpyrifos		7.6
2008	Lin et al^Citation9	679	Chlorpyrifos		4.4
2005	Eddleston et al^Citation8	439	Chlorpyrifos	15.0	8.0

Table 2 Baseline Characteristics of Patients with Pesticide Poisoning, Stratified by Type of Pesticide (n = 121)

Variable	All Patients (n = 121)	Patients with Chlorpyrifos Poisoning (n = 82)	Patients with Cypermethrin Poisoning (n = 27)	Patients with Chlorpyrifos and Cypermethrin Poisoning (n = 12)	P value
Age, year	55.4 ± 17.4	55.2 ± 17.5	56.0 ± 16.9	55.1 ± 19.7	0.979
Male, n (%)	80 (66.1)	57 (69.5)	15 (55.6)	8 (66.7)	0.413
Intentional ingestion, n (%)	113 (94.2)	76 (93.8)	26 (96.3)	11 (91.7)	0.828
Unintentional ingestion, n (%)	7 (5.8)	5 (6.2)	1 (3.7)	1 (8.3)
Ingested amount, mL	132.6 ± 164.7	111.4 ± 110.4	182.5 ± 252.7	136.7 ± 154.8	0.206
Time between pesticide ingestion and hospital arrival (hour)	4.6 ± 9.2	3.7 ± 3.9	7.4 ± 17.6	3.9 ± 1.8	0.359
Alcohol consumption habit, n (%)	36 (29.8)	23 (28)	7 (25.9)	6 (50)	0.265
Medical history of hypertension, n (%)	31 (25.6)	23 (28.0)	4 (14.8)	4 (33.3)	0.319
Medical history of diabetes mellitus, n (%)	16 (13.2)	10 (12.2)	4 (14.8)	2 (16.7)	0.878
Occupation
Farmer, n (%)	21 (18.1)	14 (17.3)	4 (16.7)	3 (27.3)	0.707
Non-farmer, n (%)	95 (81.9)	67 (82.7)	20 (83.3)	8 (72.7)
Marital status
Married, n (%)	87 (75)	62 (76.5)	16 (66.7)	9 (81.8)	0.531
Unmarried, divorced, widowed, n (%)	29 (25)	19 (23.5)	8 (33.3)	2 (18.2)

Notes: Categorical data were reported as numbers with corresponding percentages in parentheses, while continuous data was reported by the mean and standard deviation.

Table 3 Clinical Manifestations of Patients with Pesticide Poisoning, Stratified by Type of Pesticide (n = 121)

Variable	All Patients (n = 121)	Patients with Chlorpyrifos Poisoning (n = 82)	Patients with Cypermethrin Poisoning (n = 27)	Patients with Chlorpyrifos and Cypermethrin Poisoning (n = 12)	P value
Systolic blood pressure, mmHg	146.0 ± 28.9	148.1 ± 29.1	143.4 ± 25.6	137.3 ± 34.7	0.429
Diastolic blood pressure, mmHg	85.8 ± 17.4	86.6 ± 17.6	87.0 ± 16.3	77.8 ± 17.4	0.242
Heart rate, beat per minute	94.8 ± 21.2	96.4 ± 21.2	91.0 ± 22.5	92.5 ± 18.0	0.503
Respiratory system
Acute respiratory failure, n (%)	50 (41.3)	40 (48.8)	3 (11.1)	7 (58.3)	0.001**
Aspiration pneumonia, n (%)	54 (44.6)	43 (52.4)	8 (29.6)	3 (25.0)	0.042*
Cardiovascular system
Corrected QT interval, ms	471.7 ± 32.3	469 ± 32.3	476.4 ± 38.3	485.6 ± 25.0	0.528
Hypotension, n (%)	3 (2.6)	2 (2.5)	0 (0)	1 (8.3)	0.323
Urinary system
Acute kidney injury, n (%)	16 (13.9)	11 (14.1)	3 (11.5)	2 (18.2)	0.864
Neurological system
Salivation, n (%)	51 (42.5)	43 (53.1)	3 (11.1)	5 (41.7)	0.001**
Glasgow Coma scale, score	12.9 ± 5.7	12.8 ± 3.7	14.2 ± 1.9	10.4 ± 5.7	0.011*
Seizure, n (%)	9 (7.5)	6 (7.4)	1 (3.7)	2 (16.7)	0.365

Notes: Categorical data were reported as numbers with corresponding percentages in parentheses, while continuous data was reported by the mean and standard deviation. *P < 0.05; **P < 0.01.

Table 4 Laboratory Data of Patients with Pesticide Poisoning, Stratified by Type of Pesticide (n = 121)

Variable	All Patients (n = 121)	Patients with Chlorpyrifos Poisoning (n = 82)	Patients with Cypermethrin Poisoning (n = 27)	Patients with Chlorpyrifos and Cypermethrin Poisoning (n = 12)	P value
White blood cell count, 1000/uL	12.7 ± 6.6	12.8 ± 6.9	12.5 ± 6.6	12.4 ± 4.6	0.964
Hemoglobin, g/dL	13.8 ± 2.4	13.8 ± 2.3	13.8 ± 2.5	13.4 ± 2.6	0.820
Platelet count, 1000/uL	242.5 ± 66.7	242.6 ± 67.0	239.4 ± 70.0	248.3 ± 62.7	0.938
Blood urea nitrogen, mg/dL	17.3 ± 14.8	18.3 ± 16.7	13.8 ± 7.3	18.2 ± 14.1	0.512
Creatinine, mg/dL	1.2 ± 1.3	1.2 ± 1.5	1.0 ± 0.4	1.00 ± 0.4	0.591
Alanine transaminase, U/L	40.8 ± 51.6	47.8±60.6	24.4 ± 8.9	26.8 ± 13.2	0.118
Sodium, mEq/L	139.7 ± 4.4	139.8 ± 4.7	139.5 ± 3.8	139.7 ± 3.3	0.958
Potassium, mEq/L	3.5 ± 0.5	3.5 ± 0.5	3.6 ± 0.4	3.6 ± 0.5	0.628
Calcium, mg/dL	8.7 ± 1.2	8.7 ± 1.4	8.8 ± 0.6	8.4 ± 0.5	0.856
Cholinesterase, U/mL	2.5 ± 4.7	1.1 ± 2.4	11.2 ± 7.1	1.4 ± 2.3	< 0.001***
C-reactive protein, mg/L	36.8 ± 50.4	47.6 ± 56.0	11.1 ± 20.3	17.4 ± 31.3	0.175

Notes: Categorical data were reported as numbers with corresponding percentages in parentheses, while continuous data was reported by the mean and standard deviation. The laboratory information was collected upon hospital arrival. ***P < 0.001.

Table 5 Outcomes of Patients with Pesticide Poisoning, Stratified by Type of Pesticide (n = 121)

Variable	All Patients (n = 121)	Patients with Chlorpyrifos Poisoning (n = 82)	Patients with Cypermethrin Poisoning (n = 27)	Patients with Chlorpyrifos and Cypermethrin Poisoning (n = 12)	P value
Mortality, n (%)	17 (14.0)	14 (17.1)	1 (3.7)	2 (16.7)	0.214
Oxime therapy, n (%)	90 (74.4)	79 (96.3)	0 (0)	11 (91.7)	< 0.001***
Hospitalization duration, day	17.9 ± 15.8	21.0 ± 16.4	7.9 ± 9.4	19.8 ± 14.6	0.001**
Intensive care unit duration, day	9.4 ± 10.1	9.8 ± 10.9	14.7 ± 5.1	5.6 ± 4.3	0.374

Notes: Categorical data were reported as numbers with corresponding percentages in parentheses, while continuous data was reported by the mean and standard deviation. **P < 0.01, ***P < 0.001.

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