Association Between Serum Cholinesterase Levels And Clinical Outcome In Patients Of Organophosphorus Compound Poisoning – One Year Hospital Based Longitudinal Study

Abstract

Background and objectives The activity of serum cholinesterase decreases in organophosphate compound poisoning. This study was aimed to evaluate serum cholinesterase levels as a prognostic marker for patients with organophosphorus poisoning. Methodology The present one year hospital based longitudinal study was done on a total of 85 patients admitted with organophosphorus compound poisoning in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from January 2014 to December 2014. The estimation of pseudocholinesterase levels was done at the time of admission, on the fifth day and at the time of discharge. Results Maximum number of cases had age < 30 years (55.29%) and the mean age was 35.28 ± 15.34 years. There was male preponderance with a male to female ratio of 2.4:1. The most commonly consumed compound was malathion (24.71%). Majority of the patients (62.35%) presented after 3 to 6 hours of consumption. The most common symptom was vomiting (87.06%) and POP score revealed moderate intoxication in 58.82% of the patients. Serum cholinesterase levels were profoundly low (≤ 2500 U/L) in 62.35% of the patients at admission, 65.33% on fifth day and 62.71% at the time of discharge. Acute renal failure was the most common complication, noted in 23.08% of the patients. Mortality was noted in 15.29% of the patients and intermediate syndrome was the commonest cause (30.77%). Conclusion and interpretation There is a positive association of serum cholinesterase with hospital stay (first day levels and serial estimation); requirement of ventilatory support (first day levels); and outcome (serial estimation).