Serum ubiquitin C-terminal hydrolase L1 predicts cognitive impairment in patients with acute organophosphorus pesticide poisoning.

Abstract

BackgroundTo assess the usefulness of serum C‐terminal hydrolase L1 (UCH‐L1) level as a biomarker for predicting cognitive impairment in patients with acute organophosphorus pesticide poisoning (AOPP).MethodsTwo hundred and seven adult patients with AOPP were included in this study. Serum UCH‐L1 levels were assessed on admission (Day 1 postpoisoning) and on Days 3 and 7 postpoisoning. The associations between serum UCH‐L1 levels, other clinical predictors, and cognitive function evaluated on Day 30 postpoisoning were investigated.ResultsOn multivariate analysis, serum UCH‐L1 levels on admission (odds ratio [OR] 1.889, 95% confidence interval [CI] 1.609‐3.082, P = 0.002) and 24‐hour APACHE II score (OR 1.736, 95% CI 1.264‐3.272, P = 0.012) were independent predictors of cognitive impairment on Day 30 postpoisoning. Based on the receiver operating characteristic curve, serum UCH‐L1 levels >5.9 ng/mL on admission predicted cognitive impairment on Day 30 postpoisoning with 86.1% sensitivity and 72.5% specificity (area under the curve, 0.869; 95% CI 0.815‐0.923). On admission [8.51 (6.53‐10.22) ng/mL vs 4.25 (2.57‐6.31) ng/mL, P < 0.001] and Day 3 [9.31 (7.92‐10.98) ng/mL vs 3.32 (2.25‐5.13) ng/mL, P < 0.001] and Day 7 [4.96 (3.28‐7.26) ng/mL vs 2.27 (1.55‐3.24) ng/mL, P < 0.001] postpoisoning, serum UCH‐L1 concentration was significantly higher in patients that developed cognitive impairment compared to those that did not.ConclusionThis study demonstrates that serum UCH‐L1 level has potential as a novel biomarker for predicting cognitive impairment 30 days after AOPP.