A study on serum cholinesterase levels as a prognostic marker in organophosphorus poisoning

Abstract

Background: Organophosphorus compound poisoning is the most common medico toxic emergency in India. Respiratory failure is the most common complication of OP poisoning leading to death. Materials and methods: Cross sectional study was done in Cases with history of exposure to organophosphorus compound within previous 24 hours was chosen after applying inclusion and exclusion criteria. Patients were evaluated for Peradeniya OP poisoning scale and serum cholinesterase levels for assessment of severity of poisoning. Serum cholinesterase levels and Peradeniya OP poisoning scale were studied to predict the complications and prognosis. Results: In our study ventilatory support required in 27.5% of patients. Mortality in our study was 17.5%. Only 15% of patients with mild grade of poisoning according to Peradeniya OP poisoning scale required ventilatory support, where as 85% did not require ventilatory support. Most of patients with moderate (45%) and severe poisoning (57%) according to Peradeniya OP poisoning scale required ventilatory support. 91% of patients with serum cholinesterase levels more than 50% did not require ventilatory support. Only 34% of patients with serum cholinesterase levels less than 50% required ventilatory support. In our study there was no significant correlation between initial serum cholinesterase levels and the need for ventilator support. Conclusion: No significant increase in serum cholinesterase levels with treatment in patients with poor prognosis and correlated with mortality. Serial measurement of PChE levels useful in predicting outcome and incidence of neurological complications.