CORRELATION OF CLINICAL SCORE AND SERUM ACETYLCHOLINESTERASE LEVEL, AS A PREDICTOR OF OUTCOME AMONG PATIENTS WITH ACUTE ORGANOPHOSPHATE POISONING ADMITTED IN EMERGENCY WARD OF TERTIARY HOSPITAL IN EASTERN NEPAL
Journal Title: INTERNATIONAL JOURNAL OF PURE MEDICAL RESEARCH - Year 2017, Vol 2, Issue 9
Abstract
Introduction: Organophosphorus (OP) insecticide self-poisoningis a major clinical and public health problem across much of rural Asia with hundreds of thousands of deaths each year.Owing to the limited availability of facilities and resource constrained settings, it is necessary to rely on clinical scores to assess the poisoning severity. Monitoring a patient's serum acetyl cholinesterase status after organophosphate poisoning enables the verication of substantial exposure to anticholinesterase agents. The present study was done to correlate serum acetylcholinesterase level with POP (Peradeniya Organophosphorus Poisoning) score with outcome among patients with acute organophosphate poisoning. Methods: A cross-sectional study was conducted amongst the patients fullling the inclusion criteria were included and patients were categorized according to POP scale. The study was conducted at B.P Koirala Institute of Health Sciences in the period of Jan 2016 to Dec 2016. POP score was applied and serum acetylcholinesterase level was estimated. Spearman's Rho Coefficient and Kruskal- Wallis statistical methods were applied for correlation and variables and P value of <0.05 was considered as signicant. Results: The correlation between severity of poisoning as assessed by POP scale and serum acetylcholinesterase was signicant (P= 0.01). Spearman's Rho Coefficient showed 0.471 is a better negative correlation between POP score and serum acetylcholinesterase level. Serum acetylcholinesterase level also correlated better with POP score for the need of Atropine vs. Pralidoxime (PAM) (Coefficient=0.449 vs. 0.427; P= 0.01) and (Coefficient= 0.589 vs. 0.33; P= 0.01). Serum acetylcholinesterase correlated well with the length of hospital stay (Coefficient= 0.374;P= 0.01) as compared to POP score (Coefficient= 0.244; P= 0.05). Kruskal-Wallis test correlated well with POP score, Serum acetylcholinesterase level and duration of hospital stay (P= 0.004, P= 0.021 and P= 0.010 respectively). Conclusions: POP scale and Serum acetylcholinesterase level had shown well negative correlation and enhances these tools to be used in predicting outcome among patients with acute organophosphate poisoning.
Authors and Affiliations
Ritesh Chaudhary, Rabin Bhandari, Gyanendra Malla, Madhab Lamsal, Masum Poudel
Keywords
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