Role of Serial Serum Cholinesterase Levels in Clinical Outcomes of Patients with Organophosphorus Compound Poisoning: A Cohort Study

Abstract

Introduction: Poisoning is caused, when a poisonous material is consumed, inhaled, or comes into contact with the skin, eyes, or mucous membranes like the mouth or nose. Poisoning by pesticides has long been considered a serious public health issue. The majority of poisoning cases reported to hospitals involve either an unknown type and quantity of Organophosphorus (OP) poisoning taken by the patient, which makes repeated serum Acetylcholinesterase measurements. Few studies have done the serial Serum Cholinesterase(SChE) tests in the early stages of poisoning. Aim: To evaluate the prognostic value of measuring serial SChE levels in patients with OP poisoning to predict clinical outcomes. Materials and Methods: This cohort study was conducted in the Department of Biochemistry and Therapeutics at Hassan Institute of Medical Sciences, Karnataka, India. Medical records of OP poisoning cases admitted during September 2023 and December 2023. A total of 40 patients were included in the study. Detailed demographic and clinical data, along with serial SChE levels at admission, day 2, and day 4, were recorded in the case record forms. Results: The mean age of the patients was 43.38±16.46 years. There was a significant decrease in serum SChE levels from day 1 to day 4 (p<0.0001). Furthermore, the mean SChE levels at admission in patients who survived were significantly higher (p<0.00001) than those in the group that expired. Conclusion: Significantly higher SChE levels were found to be associated with improved clinical outcomes, as indicated by improvements in mechanical ventilation and lower fatality rates after acute OP poisoning.

Keywords

• clinical severity
• pesticides
• mechanical ventilation