Relation of Serum Cholinesterase with Clinical Severity and Treatment Outcomes of Organophosphorus Poisoning in a Tertiary Care Center, a Prospective Observational Study

ABSTRACT

Introduction: Acute organophosphorus (OP) pesticidepoisoning is widespread and is the most common poisoningin many developing countries and vary in differentgeographic regions. Organophosphorus compounds are antiacetylcholinesterase’s which exert their toxicity by interferingwith the normal function of acetylcholine. So the present studywas done to assess the serum cholinesterase levels correlationwith clinical severity to determine the treatment outcome(Need for mechanical ventilation and mortality).Material and methods: A cross-sectional study wasconducted among 100 patients admitted with OPC poisoningin the department of general medicine, Velammal MedicalCollege Hospital and Research Institute, Madurai fromJanuary 2016 to July 2019. The diagnosis was made basedon history or evidence of exposure to OP compound within24 hours; Clinical severity was assessed and categorizedaccording to POP scale. Serum Cholinesterase values weredefined as per Proudfoot classification. IBM SPSS version 22was used for statistical analysis.Results: OP poisoning predominantly affected males in theage group 21 to 40 years. The majority had a moderate gradeof poisoning with Serum cholinesterase levels between 2001to 5000 (IU/l). In this study, the mortality was 25%, and 40%of patients had to be ventilated. There was no statisticallysignificant relationship between age, gender, clinical severity,time-lapse, Serum cholinesterase levels, mortality withmechanical ventilation. Mortality rate showed a statisticallysignificant relation with clinical severity (p<0.001).Conclusion: Clinical severity was associated with treatmentoutcomes. No particular trend of the association was observedbetween clinical severity and serum cholinesterase levels.Serum cholinesterase levels had shown no association withoutcomes: