Çukurova Üniversitesi Tıp Fakültesi Dergisi (Apr 2013)
Relationship between mortality and acute inflammatory markers, erythrocyte cholinesterase, serum cholinesterase levels in the acute organic phosphorus intoxication
Abstract
Aim: In our study, we aimed to investigate the relationship between the mortality and acute inflammatory markers, serum - erythrocyte cholinesterase levels in patients with organophosphorus poisoning. Material and Methods: We planned to take patients who administered to emergency department with organic phosphorus poisoning prospectively for 2 years after approval by the Ethics Committee of Cukurova University. Patients with hereditary cholinesterase deficiency, liver disorders, malnourished, anemia, using cocaine, morphine, codeine, and medications such as succinylcholine were excluded from the study. A total of 39 patients were included in the study. Standard data entry form has been created. Blood samples were taken from all of the patients included in the study for use in study after diagnosis. White blood cell (WBC) and platelet counts, fibrinogen, ferritin, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-á), interleukin-1 (IL-1), interleukin 6 (IL-6), interleukin 10 (IL-10), erythrocyte and serum cholinesterase levels were determined from blood samples in Central Laboratory of Hospital of Balcali in Cukurova University School of Medicine. SPSS 18.0 package program was used for statistical analysis of data. The statistical significance level of all tests was p <0.05. Results: The laboratory data of patients who died due to organophosphorus poisoning were compared with the patients discharged; the mean serum cholinesterase levels of the patients who died were statistically low (p = 0.006), platelet counts were low (p = 0.031), fibrinogen levels were high (p = 0.011). However, there was no statistically significant differences between erythrocyte cholinesterase (p = 0.984), IL-1 (p = 0.139), IL-6 (p = 0.513), IL-10 (p = 0.089), TNF-á (p = 0.074), CRP (p = 0.081), ferritin (p = 0.275), WBC (p = 0.272) levels of the patients who died or discharged. There was a statistically significant relationship between fibrinogen levels and erythrocyte cholinesterase (p = 0.013), serum cholinesterase (p = 0.029) levels of the patients who discharged or died. Conclusion: Low serum cholinesterase levels, low platelet count and high fibrinogen levels were found to be important factors for the high mortality rate of organic phosphorus poisoning. This study will be useful for emergency physicians to be able to predict mortality of organic phosphorus poisoning and contribute to more clinical experiences. These laboratory tests can be used as prognostic markers after more detailed studies. [Cukurova Med J 2013; 38(2.000): 233-240]
