Predicting outcome and severity in acute organophosphorous poisoning with clinical scoring and serum cholinesterase levels

Citation metadata

Authors: Basavaraj R. Patil Raikod, Niraj Saraf and Sudhanva V. Kinhal
Date: Nov. 10, 2014
From: Journal of Evolution of Medical and Dental Sciences(Vol. 3, Issue 60)
Publisher: Akshantala Enterprises Private Limited
Document Type: Medical condition overview
Length: 2,345 words

Main content

Abstract :

BACKGROUND AND OBJECTIVES: Organophosphorus compound poisoning is the most common medico toxic emergency in India the increase in pesticide use in agriculture has paralleled the increase in the use of these products for deliberate self-warm. Respiratory failure is the most common complication of OP poisoning leading to death. Early recognition and prompt ventilator support may improve survival. Owing to limited availability of resources, all OP poisoning patients are not managed in ICUs in Indian setup. It is therefore important that clinical features and criteria to predict the need for ventilator support be identified at initial examination. Hence this study was undertaken to assess the severity of organophosphorus compound poisoning both clinically by using Peradeniya scoring and by estimating serum choline esterase levels. METHODS: Cross sectional study was done at basaveswar teaching and general hospital attached to MR Medical College. Cases with history of exposure to organophosphorus compound within previous 24 hours were chosen after applying inclusion and exclusion criteria. Patients were evaluated for Peradeniya OP poisoning scale and serum cholinesterase levels for assessment of severity of poisoning. Serum cholinesterase levels and Peradeniya OP poisoning scale were studied to predict the need for ventilator support. The results were analyzed using Chi-square test. STATISTICAL ANALYSIS: It was done using pearson's chi square test. RESULTS: In this study requirement of ventilator support was seen in 36% of patients. Mortality in our study was 18%. Only 15.6% of patients with mild grade of poisoning according to Peradeniya OP poisoning scale required ventilator support, whereas 84.4% did not require ventilator support. Most of patients with moderate (70.6%) and severe poisoning (100%) according to Peradeniya OP poisoning scale required ventilator support. 93.7% of patients with serum cholinesterase levels more than 50% did not require ventilator support. 85% of patients with serum cholinesterase levels less than 50% required ventilator support. Our study showed a highly significant correlation between serum cholinesterase levels and the need for ventilator support. CONCLUSION: Serum cholinesterase levels were significantly depressed in patients who required ventilator support and correlated with mortality. Miosis, Bradycardia, increased respiratory rate, impaired level of consciousness, all these parameters correlated well with need for ventilator support. Peradeniya OP poisoning score of more than 5 correlated in predicting the need for ventilator support and mortality. KEYWORDS: Op poisoning, Pop scoring.

Source Citation

Source Citation
Raikod, Basavaraj R. Patil, et al. "Predicting outcome and severity in acute organophosphorous poisoning with clinical scoring and serum cholinesterase levels." Journal of Evolution of Medical and Dental Sciences, vol. 3, no. 60, 10 Nov. 2014, pp. 13360+. Accessed 27 Nov. 2021.
  

Gale Document Number: GALE|A467679555