Study of Level of Total Serum Creatine Phosphokinase as Prognostic Indicator in Acute Organophosphorus Poisoning: A Prospective Study
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 2
Abstract
Introduction: Poisoning has been found to be a major cause of death or morbidity in the developing world, the commonest being Organophosporus (OP) poisoning. Erythrocyte cholinesterase (EchE) and pseudocholinesterase (Butyryl cholinesterase – BchE) are markers used for assessing the severity in OP poisoning, but estimation of these are costly, has variable values for different individuals and are not available at all centers. This study was done to estimate levels of serum Creatine Phosphokinase (CPK) serially in acute OP poisoning patients and to correlate with Peradeniya Organophosphorus Poisoning (POP) score to predict the prognosis. Material and methods: 64 patients of acute organophosphorus poisoning admitted to S.Nijalingappa medical college and HSK hospital over a period of one year from 1st January 2015 to 31st December 2015 were taken up for the study. 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 64 patients, 67% were males and 33% were females. Majority of patients were in the age group 21 – 40 years. Chlorpyrifos was the most common compound used followed by Methyl parathion. 83% had mild, 11% had moderate and 6% 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 initial serum CPK levels is associated with severe degree of poisoning and is associated with complications and mortality. CPK levels normalises by day 5 in uncomplicated cases but continues to be high in complicated cases.
Authors and Affiliations
Raghavendra Mural, Gopal Bajaj, Denny Mammen
Keywords
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