Clinical Profile, Severity Assessment, Management and Outcomes of Acute Organophosphate Poisoning: A Prospective Observational Study

Objectives: To study the epidemiological profile, clinical presentation, severity assessment using the Peradeniya Organophosphorus Poisoning (POP) score, treatment patterns, and clinical outcomes of patients with acute organophosphate poisoning. Methods: This prospective observational study was conducted in the Emergency Medicine Department of a tertiary care hospital in Western India from September 2023 to September 2025. A total of 120 patients with confirmed acute organophosphate poisoning were included. Demographic details, clinical features, POP score at admission, atropine requirement, ICU admission, need for mechanical ventilation, and in-hospital outcomes were recorded. Statistical analysis was performed using the Chi-square test, and a p-value < 0.05 was considered statistically significant. Results: The mean age of patients was 33.85 ± 14.65 years, with a marked male predominance (87.5%). Most patients were from rural areas and suicidal ingestion was the commonest mode of poisoning. Based on POP score at admission, 38.3% of patients had mild, 59.2% had moderate, and 2.5% had severe poisoning. ICU admission and mechanical ventilation were required in 22.5% of patients each. Mean atropine requirement increased with severity of poisoning (29.04 mg in mild, 55.44 mg in moderate, and 143.33 mg in severe cases). Overall mortality was 10% and increased significantly with POP score severity (χ² = 13.42, p = 0.0006). Conclusion: Acute organophosphate poisoning predominantly affects young adults and continues to cause significant morbidity and mortality. The POP score is a simple and effective bedside tool for early severity assessment and outcome prediction. Higher POP scores are associated with increased atropine requirement, need for intensive care, mechanical ventilation, and mortality. Routine use of POP scoring in emergency departments can aid in early triage, appropriate management, and optimal resource utilization.