A Study of Serum Cholinesterase Activity with Clinical Correlation in Patients with Acute Organophosphorous Poisoning

Abstract

Background: Organophosphorus (OP) compounds acts by inhibiting cholinesterase activity. Estimation of serum AChE levels is done to assess the severity of OP poisoning. This study was planned to evaluate the correlation between the level of serum AChE enzyme and the clinical outcome so that the findings can be used for management of these critical patients. Material and methods: A prospective study was conducted on 100 patients with OP compound poisoning. Serum AChE levels were estimated in all patients before administration of any treatment. Patients were classified into 4 grades of severity of poisoning as per the Namba et al. criteria and were treated accordingly. Results: Serum AChE level in patients with the latent grade of poisoning was 5643.76± 1627.83 IU/L, in patients with a mild grade of poisoning was 3178.8±530.30 IU/L, in patients with moderate grade of poisoning was 2360±273.12 IU/L and in the severe grade of poisoning was 521.68±288.8 IU/L. Out of 48 patients with latent grade of poisoning 91.66% recovered. In a moderate grade of poisoning, 50% recovered while 30% died and with severe grade of poisoning 32.43% patients recovered while 51.35% patients died. Conclusion: Estimation of serum AChE level on admission act as a good tool to predict the prognosis of the patient as low levels of serum AChE are associated with bad prognosis and higher chances of mortality.