Prognostic Significance of Creatine Phospokinase (CPK) Levels in Assessing the Severity of Organophosphorus Poisoning Compound Poisoning

Abstract

Organophosphorus poisoning (OP poisoning) is common poisoning specially in developing countries like India. This compound is easily available, cheap and is used in agricultural field as pesticides. Both accidental and suicidal poisoning has been reported. Laboratory parameters like erythrocyte cholinesterase activity has been used to support clinical diagnosis and to predict prognosis and it is costly. Pseudocholinesterase is cheaper alternative but it is less reliable. There are few other biochemical markers including CPK which is usually raised in cases of acute OP poisoning and it is a cheaper investigation and is easily performed in all laboratories. Hence this study was done to evaluate role of creatine phosphokinase levels to support clinical diagnosis as well as predicting prognosis in acute OP compound poisoning. Materials and Methods: It was a prospective observational study which included 50 patients who presented within 6 hours of consumption of OP compound afterconsidering inclusion and exclusion criteria. Patients were categorized into mild, moderate and severe poisoning according to POP score and initial CPK levels were noted. Data expressed in percentages and chi-square test was used to know statistical significance. Results: Out of 50 patients, 28 (56%)had mild, 16 (32%) had moderate and 6 (12%) had severe poisoning. Initial CPK levels were positively correlated with POP score. Four deaths occurred in our studyout of which one had moderate poisoning and threehad severe poisoning. Conclusion: Initial CPK levels correlated with severity of OP compound poisoning and mortality.