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

ABSTRACT

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, 1213] 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: