prognostic value of the Glasgow coma scale, serum acetylcholinesterase and leukocyte levels in acute organophosphorus poisoning

Organophosphate poisoning [OP] is a serious clinical condition that may sometimes be fatal. The aim of this study was to determine whether the Glasgow coma scale [GCS], and serum acetylcholinesterase and leukocyte levels have prognostic value in acute OP poisoning. Retrospective review of records of patients admitted to the intensive care unit of Selcuk University, Meram Medical Faculty, Emergency Department, Konya, Turkey, between January 2006 and January 2009. We studied acutely OP-poisoned patients admitted within 24 hours after OP exposure. The mean age of the 25 patients was 37 years [range, 20-80 years]. Three [12%] of the 25 patients [male-female ratio, 12:13] died. The mean GCS values of the patients who died were significantly lower compared to those of the group that survived [4 vs 11.7, respectively P<.05]. While the mean serum acetylcholinesterase levels were lower in the patients who died, the difference in the mean serum acetylcholinesterase levels between the patients who died and the ones who survived was not statistically significant [3841 IU/L vs. 1768 IU/L, respectively]. Although serum cholinesterase values can be used in the quick diagnosis, their efficiency at predicting outcome in patients with OP poisoning has not been established. It has also been determined that serum leukocyte values have no prognostic value in OP poisoning, but GCS values have been found to be effective in predicting the outcome

prognostic value of trauma scoring systems for gunshot injuries

We aimed to evaluate the trauma scoring systems on gunshot injured patients to predict trauma severity. All patients with gunshot injury admitted to the emergency department [ED] from January 2007 through January 2009 were enrolled in the study. The demographic characteristics of patients such as age, gender, cause of the injury, type of the weapon used, the injured body parts, Glasgow Coma Scale [GCS], Shock Index [SI], the length of stay in the hospital and mortality were recorded from the patient charts. Injury Severity Score [ISS], Revised Trauma Score [RTS] and Trauma and Injury Severity Score [TRISS] have been calculated. The differences between the groups for these parameters were compared using the Mann-Whitney U test. The mean age of patients was 33.2 +/- 16.1 and 79 of 87 patients were male. The causes of GSIs were homicidal in 73.6% and bullet cartridge in 51.7%. Calculated GCS, ISS, RTS, TRISS and SI were 13.8 +/- 2.9, 13.0 +/- 9.3, 7.38 +/- 1.1, 93.9 +/- 14.9% and 1.9 +/- 0.9 respectively. GCS, RTS and TRISS scores for survivors were significantly higher than non-survivors [p<0.001]. ISS score and SI for survivors were significantly lower than non-survivors [p<0.001]. There were no statistically significant differences between the groups in terms of the length of stay in hospital [p>0.05]. There was no statistically significant correlation of the length of stay in hospital with GCS, RTS and TRISS [p>0.05]. The length of stay in hospital was found to correlate with ISS and SI positively [p<0.001]. It is concluded that Gun Shot Injury [GSI] is much more likely in young males than the other types of trauma in the population. We recommend that trauma scoring systems should be used to show trauma severity and mortality