RETROSPECTIVE STUDY OF ORGANOPHOSPHORUS POISONING PATIENTS WITH REFERENCE TO CLINICAL PRESENTATION, SERUM CHOLINESTERASE LEVEL AND OUTCOME TO TREATMENT

Abstract

The present study was conducted to analyze Organophosphorus poisoning patients with respect to serum cholinesterase level and get an idea of its correlation with various other factors to predict clinical course, severity and outcome of treatment. This was a retrospective study of 6 months duration (July 1st – December 31st 2017) conducted in General Medicine and Record & Statistics Department of tertiary care hospital. The study was approved by the Institutional Ethics Committee. All the patients of OP poisoning and patients with clinical features suggestive of OP poisoning, irrespective of age/sex were included in the study. Non-OP poisoning patients, patients with renal failure and with multiple poisoning with other drugs such as opioids, diazepam, barbiturate, etc were excluded. Out of 262 poisoning cases in this study, 46 cases were OP poisoning. Sex ratio (M:F) is 3.6:1 and 16-30 yrs age group was most commonly affected, unmarried and belonging to rural area. Suicidal being the most common manner of OP poisoning and by oral route. Family stress in case of suicidal poisoning and alcohol influence for accidental poisoning emerged to be the most common reasons. The mean SCE level is 4491 ± 4128 U/L. Most cases were found to be in the range of 1000-2000U/L (32.6%). Mortality rate in this study was only 13%, due to the close proximity of medical facilities available in our region. Vomiting was found to be the most common clinical feature, followed by giddiness and miosis. Hospital stay duration was seen to be more in patients with low level of SCE (< 2000 U/L). Duration of ventilation needed was more among the patients with low level of SCE (< 2000 U/L). But, SCE level did not show any correlation with treatments outcome, blood pressure, respiratory rate, breathlessness, vomiting and unconsciousness. Treatments outcome worsened with increase in gap between OP consumption and hospital admission.