Association between time to atropine initiation and hospital length of stay in acute organophosphate poisoning: A retrospective cohort study

Khadijeh Saravani; Dadkhoda  Soofi; Amirhossein Azariyan; Soleyman  Saravani; Pantea  Ramezannezhad

doi:10.66224/

Authors

Khadijeh Saravani Department of Community Medicine, School of Medicine, Pediatric Gastroenterology and Hepatology Research Center, Amir al Momenin Hospital, Zabol University of Medical Sciences, Zabol, Iran
Dadkhoda Soofi Department of Internal Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
Amirhossein Azariyan Student Research Committee, Zabol University of Medical Sciences, Zabol, Iran
Soleyman Saravani Department of Community Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran https://orcid.org/0000-0001-7239-9872
Pantea Ramezannezhad Department of Emergency Medicine, School of Medicine, Kashani Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran https://orcid.org/0000-0002-9152-2036

DOI:

https://doi.org/10.66224/

Keywords:

Organophosphate Poisoning, Hospital Length of Stay, Atropine, Time-to-Treatment

Abstract

Acute organophosphate poisoning is a leading cause of morbidity worldwide. While early atropine administration is standard treatment, its effect on hospital length of stay remains unclear. This study evaluated the association between time to atropine initiation and hospital length of stay in organophosphate poisoning. This cross-sectional study was conducted on 62 hospitalized patients with clinically diagnosed acute organophosphate poisoning. Time-to-atropine was defined as the interval (minutes) from poisoning onset to first intravenous atropine dose. It was analyzed both as a continuous variable and categorically (≤60 minutes vs. >60 minutes). The primary outcome was hospital length of stay (days). Independent t-tests compared hospital length of stay between groups. Multivariable linear regression assessed the independent association between atropine timing and LOS after adjusting for age, sex, and comorbidities. The mean age was 35.04 ± 17.57 years, and 51.6% were female. The mean time to atropine administration was 131.53 ± 106.23 minutes. Early atropine initiation (≤60 minutes) was associated with a significantly shorter length of stay compared with delayed initiation (2.46±1.36 vs. 4.33±2.11 days; p = 0.001). In multivariable analysis, early atropine administration was independently associated with a 1.95-day reduction in length of stay (B=−1.95; 95% CI: −2.93 to −0.98; p<0.001). No significant associations were observed for age, sex, or comorbidities (p>0.05). Delayed atropine administration beyond 60 minutes was independently associated with prolonged hospitalization in acute organophosphate poisoning.

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