Relevance of Pseudo Cholinesterase Level to Clinical Profile as Prognostic Marker on Organophosphorus Compound Poisoning

Abstract

Background: Organophosphorus poisoning has a high mortality rate. Various factors decide prognosis of organophosphate poisoning. This study is carried out to analyze the significance of estimation of serum pseudo cholinesterase in assessment of severity as well as prognosis in OP poisoning. Materials and Methods: This prospective study was conducted at department of Medicine in McGann teaching hospital attached to Shimoga institute of medical sciences from June 2017 to December 2017. Total of 123 documented OP patients were analyzed. Noting of symptoms, signs, need of oxygen, ventilator support and their assessment with PChE levels carried out. Informed consent was taken from each study participant. Ethical committee approval was obtained to carry out the study. Suitable statistical methods applied to assess correlation and variables. Results: Among 123 patients, majority were male (64.2%), belonged to 21-30 age group (34.1%), were from rural areas (91%) and commonest compound ingested is chlorpyrifos (60.9%).Patients needing ventilator support were 3, 13 and 43 in patients of moderate poisoning, severe poisoning and very severe poisoning respectively, where as it was none in patients with mild poisoning and normal PChE levels. There were 21 deaths in very severe poisoning patients where as it was 4 and 1 in severe and moderate poisoning patients respectively and none in mild poisoning patients and in patients with normal PChE levels. Conclusions: Significant correlation (p value <0.001) was observed between PChE levels with clinical manifestations, need of mechanical ventilation and in hospital outcome. These findings can enforce the evaluation of patient’s prognosis, complications and treatment plan.