Serum amylase as a prognostic marker of organophosphate poisoning

Background : Elevated leukocytes level at admission is a common finding in patients with organophosphates poisoning. It has been suggested as a prognostic marker. Since early leukocytosis is frequent and mulifactorial in origin, we hypothesized that leukocytes level after 24 hours may be a better predictor of mortality.Objectives : To evaluate the prognostic value of leukocytes level at admission; and at 24-48 hours in organophosphate poisoning.Methods : A hospital based, retrospective, cohort study of patients with organophosphate poisoning was conducted in Manipal Teaching Hospital, Pokhara, Nepal. After obtaining ethical clearance from Institutional research committee, records of patients presenting with poisoning were reviewed. 103 records were considered eligible for study. Relevant data were collected in a preformed pro forma and statistical analyses were carried out.Results : Mean age of 103 participant was 29.4 (SD=11.68). Out of them 57% were females and 43% were males. T-test was applied to test for difference in age, blood pressure, leukocytes at admission, at 24-48 hrs and blood sugar of those patients with different outcomes. Except for leukocytes levels at admission (p=0.104), statistically significant difference was seen in all other parameters (p<0.001). Logistic regression analysis indicated that leukocytes levels at 24-48 hrs (B=0.002, p=0.013) is a better predictor of mortality than leukocytes levels at admission (B=0.000, p=0.034).Conclusion : Our analysis supports the hypothesis that leukocytes level at 24-48 hrs is a better predictor of mortality than leukocytes level at admission. However further study with a prospective design is recommended to confirm or refute the hypothesis.

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―A Study on Serum Amylase Level And Prevalence of Acute Pancreatitis in Organophosphate Poisoning‖

IOSR Journal of Dental and Medical Sciences ◽

10.9790/0853-1509067198 ◽

2016 ◽

Vol 15 (09) ◽

pp. 71-98

Author(s):

Dr Kumar Pankaj Shah ◽

Dr M Rajkumar ◽

Dr S Senthur Raja Pandian ◽

Dr C Dharmaraj

Keyword(s):

Acute Pancreatitis ◽

Serum Amylase ◽

Organophosphate Poisoning ◽

Amylase Level ◽

Serum Amylase Level

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A study of serum amylase as a probable prognostic marker in acute organophosphorus poisoning

APIK Journal of Internal Medicine ◽

10.4103/ajim.ajim_79_20 ◽

2021 ◽

Vol 9 (2) ◽

pp. 94

Author(s):

CN Mohan ◽

KR Raveendra

Keyword(s):

Prognostic Marker ◽

Serum Amylase ◽

Organophosphorus Poisoning ◽

Acute Organophosphorus Poisoning

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Correlation of Serum Amylase, Lipase and Creatine Kinase with Severity of Organophosphate Poisoning- A Cohort Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49962.15117 ◽

2021 ◽

Author(s):

Noas Tobias Minz ◽

Sarat Chansra Singh ◽

Priyabrata Jena ◽

Pranay Kumar Patro

Keyword(s):

Creatine Kinase ◽

Cohort Study ◽

Rural Areas ◽

Serum Amylase ◽

Hospital Admissions ◽

Acetylcholine Esterase ◽

Serum Cholinesterase ◽

Organophosphate Poisoning ◽

Mean Values ◽

Organophosphorus Poisoning

Introduction: Organophosphate Compounds (OP) are widely used pesticides in agriculture. It is easily available and OP poisoning is most common cause of poisoning and hospital admissions. Severe poisoning is associated with high mortality. Severity of poisoning can be assessed by Peradeniya Organophosphorus Poisoning (POP) scale, Acute Physiology and chronic Health Evaluation (APACHE) II, Glasgow Coma Scale (GCS) or serum Cholinesterase Level (ChE). Serum amylase, lipase, and creatine kinase are important biomarkers raised in OP poisoning. Aim: To correlate serum amylase, lipase, and creatine kinase with severity of OP poisoning. Materials and Methods: This was a hospital based observational cohort study conducted on 130 patients of organophosphate poisoning admitted in General Medicine wards of SCB Medical College, Cuttack, Odisha from June 2019 to December 2020. Serum Acetylcholine Esterase (AChE), amylase, lipase and creatinine kinase were estimated at admission, day 2, and at discharge. Other routine investigations were done. Acetylcholine Esterase (AChE) was used to confirm the diagnosis. The severity of poisoning was assessed using POP scale and graded as mild, moderate and severe. The severity of poisoning and the level of enzymes were correlated. The parameters were tabulated and mean values and Standard Deviation (SD) were analysed using Statistical Package For The Social Sciences (SPSS) software version 22.0. Results: Out of 130 patients 91 were males and 39 were females, mostly from rural areas, both farming and non-farming community. Age ranged from 14 years to 79 years, with majority in 19 to 39 years. AChE decreased in all cases depending on severity confirming OP poisoning. Severity as assessed by POP score were mild (52 patients), moderate (46 patients) and severe (32 patients). At admission, the Amylase (U/L), Lipase (U/L), and Creatine kinase (U/L) level (mean±SD) in mild poisoning were 83.7±41.9 U, 70.9±18.6, 72.5±34.9, in moderate poisoning 153.6±109.7, 91.9±47.4, 92.6±81.5, and in severe poisoning 243.9±113.8, 195.3±147.7, 298.8±207.4, respectively. Measurements on second day also remained elevated. Among the severe cases 24 patients developed Intermediate Syndrome (IMS), and 26 patients died. There was positive correlation between increase of enzyme levels and the severity of OP poisoning as per POP score. Conclusion: Serum amylase, lipase, and creatine kinase level correlated well with the severity of organophosphorus poisoning and scan be used additionally as an indicator to assess the severity. Serum amylase is a better indicator of severity than lipase and Creatine Kinase (CPK).

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A prospective study to assess glycemic status as a possible prognostic marker in non diabetic acute organophosphate poisoning patients

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20200659 ◽

2020 ◽

Vol 7 (3) ◽

pp. 464

Author(s):

Raveendra K. R. ◽

Chandana V. ◽

Sanjana Kodur

Keyword(s):

Prognostic Marker ◽

Prognostic Indicators ◽

Organophosphate Poisoning ◽

Glycaemic Variability ◽

Medical College ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Resource Limited ◽

A Prospective Study ◽

Time Of Admission

Background: Organophosphates (OP) are a diverse group of insecticides used for pest control. Due to easy availability of these compounds over the counter, organophosphate poisoning continues to be a major cause of deliberate self-harm. Although choline esterase inhibition plays a key role in OP poisoning, other metabolic factors like dysglycemia contribute to the severity of poisoning. The present study attempts to assess glycaemic variability as a probable prognostic factor in acute OP poisoning. Aim of the study was to correlate the blood glucose levels with the severity and treatment outcome of acute organophosphate poisoning.Methods: 100 patients of acute organophosphate poisoning admitted in the hospitals affiliated to Bangalore Medical College and Research Institute during the study period from August 2018 to July 2019, were enrolled into the study as per the inclusion criteria and graded into mild, moderate & severe, based on Peradeniya organophosphorus poisoning (POP) scale. Random blood sugar (RBS) was estimated at the time of admission and patients were followed up till recovery/death.Results: The patients in this study were categorized into hypoglycemics (10%), euglycemics (75%) and hyperglycemic (15%). 16% of euglycemics, 30% of hypoglycemics and 60% of hyperglycemics had severe grade of poisoning. The ventilator requirements in hypoglycaemics, euglycemics and hyperglycemics were 40%,48% and 80% respectively. The outcome in terms of mortality was 8% in euglycemics group and 20% in hyperglycemics group. Hence hyperglycemia was found to be a poor prognostic marker in acute organophosphate poisoning.Conclusions: RBS at admission in acute organophosphate poisoning patients is a simple, inexpensive tool that may help to predict the clinical outcome. Early identification of the poor prognostic indicators may help in timely intervention, to reduce morbidity and mortality, especially in a resource limited country like India.

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A Cross Sectional Study of Proportion of Respiratory Failure in Patients with Organophosphate Poisoning in a Tertiary Care Hospital in South Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/310 ◽

2021 ◽

Vol 8 (21) ◽

pp. 1642-1646

Author(s):

Narayan Mullasseril Sankarapillai ◽

Mohammed Naseem Yakoobali ◽

Sreenath Sreenivasan

Keyword(s):

Respiratory Failure ◽

Serum Amylase ◽

Tertiary Care ◽

Elevated Serum ◽

Cross Sectional Study ◽

Organophosphate Poisoning ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Laboratory Investigations

BACKGROUND Due to the widespread use and availability of agricultural insecticides, acute organophosphate poisoning is becoming the most common type of poisoning in Kerala. The cause of death is thought to be a confluence of increased bronchial secretion, bronchospasm, respiratory muscle dysfunction, respiratory center depression and respiratory failure. The purpose of the study is to find the proportion of respiratory failure in patients with organophosphate poisoning. METHODS It is a cross sectional study done in 119 consenting patients who are known cases of organophosphorous (OP) poisoning satisfying the inclusion criteria. They underwent clinical assessment and laboratory investigations to assess complications of organophosphorous poisoning. Clinical features and lab findings were recorded as per protocol. RESULTS 65 out of 119 (54.6 %) had evidence of respiratory failure. Among these 65, 20 % succumbed to death (13). 56.5 % of males (48) and 50 % of females (17) developed respiratory failure. 72.2 % of patients more than 60 years (13) had respiratory failure. Majority of the cases were of chlorpyriphos poisoning 42 (35.3 %). 76.5 % (13) of dimethoate poisoning developed respiratory failure. 93.4 % (57) of patients with respiratory failure had elevated serum amylase levels. CONCLUSIONS Respiratory failure is a very common complication found in organophosphate poisoning. It is more common in males than females and its proportion increases with age. The incidence of respiratory failure is more with dimethoate. Serum amylase levels can be used as a marker for development of respiratory failure in organophosphate poisoning. KEYWORDS Organophosphate Poisoning, Respiratory Failure, Serum Amylase Levels

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