Serum Creatine Phosphokinase as Predictor of Intermediate Syndrome in Organophosphorus Poisoning
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 6
Abstract
Introduction: Organophosphate compounds are one of the most common cause of poisoning worldwide. There are emerging option for severity assessment of OP copmpound poisoning like creatine phosphokinase level. These are cheap and easily quantifiable bio marker. Study aimed to assess serum creatine phosphokinase (CPK) level in OP poisoning and to find out the correlation of serum creatine phosphokinase (CPK) level with the severity of OP poisoning Material and methods: 55 patients of acute organophosphorous poisoning admitted to medical wards and Intensive Medical Care Unit (IMCU) at Mandya Institute of Medical Science (MIMS) hospital, Mandya, during the period of July-2017 to December- 2017 was taken up for study considering the inclusion and exclusion criteria’s.The clinical severity was assessed and categorized according to Peradeniya Organophosphorous Poisoning scale. A brief history and detailed clinical examination was performed and patients were categorized on the basis of POP score. Level of serum cholinesterase and serum CPK were estimated at admission and CPK level was measured on day 3 and day 5. The outcome of these patients was evaluated. Results: Out of 55 patients, 63.6% were males and 36.4% were females. Majority of patients were in the age group 21 – 30 years. Dichlorvos was the most common compound used followed by Chlorpyrifos. 67.3% had mild, 16.4% had moderate and 16.4 had severe poisoning. Serial measurements of serum CPK levels showed significant correlation with the severity of acute OP poisoning patients. The CPK levels showed a sensitivity of 70% and a specificity of 82% with a positive predictive value of 95%. Conclusion: High serum CPK level was associated with increased risk for intermediate syndrome and increased mortality. It can be used for assessing the severity of poisoning and early intervention like putting on mechanical ventilation and preventing mortality.
Authors and Affiliations
Lokesh NK, Shivakumar K M, Anikethan G V
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