Correlation of serum cholinesterase level, clinical score at presentation and severity of organophosphorous poisoning

The aim of the study was to correlate between the clinical score described by Peradenya Organophosphorus Poisoning (POP) scale, serum cholinesterase level at presentation and severity of poisoning. Consecutive patients of organophosphorous poisoning attending Bir Hospital from August 2004 to Septemb...

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Published in:Journal of Nepal Medical Association 2008-04, Vol.47 (170), p.47
Main Authors: Rehiman, S, Lohani, S P, Bhattarai, M C
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Atropine - administration & dosage
Cholinesterases - blood
Female
Humans
Male
Middle Aged
Muscarinic Antagonists - administration & dosage
Organophosphate Poisoning
Organophosphates - blood
Poisoning - diagnosis
Poisoning - drug therapy
Poisoning - mortality
Predictive Value of Tests
Prognosis
Prospective Studies
Severity of Illness Index
Young Adult
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container_title Journal of Nepal Medical Association
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creator Rehiman, S
Lohani, S P
Bhattarai, M C
description The aim of the study was to correlate between the clinical score described by Peradenya Organophosphorus Poisoning (POP) scale, serum cholinesterase level at presentation and severity of poisoning. Consecutive patients of organophosphorous poisoning attending Bir Hospital from August 2004 to September 2005 were studied. Patients were grouped into mild, moderate and severe poisoning groups according to the POP scale. Fifty patients fulfilled the inclusion criteria. The severity of poisoning directly correlated with serum cholinesterase level (P
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Consecutive patients of organophosphorous poisoning attending Bir Hospital from August 2004 to September 2005 were studied. Patients were grouped into mild, moderate and severe poisoning groups according to the POP scale. Fifty patients fulfilled the inclusion criteria. The severity of poisoning directly correlated with serum cholinesterase level (P&lt;0.001). The differences in the mean requirements of atropine on the first day of admission, in the total amount of atropine needed to treat and in the average duration of hospital stay were significant (P&lt;0.05). There were 26% patients in moderate poisoning and only 4% patients in severe poisoning, but a total of 14% of the patients died, indicating that patients with even moderate degree of poisoning had also died. Both the POP scale severity and derangement in serum cholinesterase levels at initial presentation did not correlate with mortality, which could be due to various other co-morbidities and inadvertent stoppage of atropine infusion particularly at night in the wards. The POP scale and serum cholinesterase at presentation appeared useful to assess the severity of poisoning, particularly in terms of higher amount of atropine and prolonged duration of hospital stay. The patients with evidence of moderate and severe degrees of poisoning need close monitoring. Further studies to evaluate the factors likely to cause deaths, particularly by closely monitoring of moderate and severe organophosphorous poisoning in intensive care units, are required to clarify the correlation with mortality.</description><identifier>ISSN: 0028-2715</identifier><identifier>EISSN: 1815-672X</identifier><identifier>DOI: 10.31729/jnma.306</identifier><identifier>PMID: 18709030</identifier><language>eng</language><publisher>Nepal: Nepal Medical Association</publisher><subject>Adolescent ; Adult ; Aged ; Atropine - administration &amp; dosage ; Cholinesterases - blood ; Female ; Humans ; Male ; Middle Aged ; Muscarinic Antagonists - administration &amp; dosage ; Organophosphate Poisoning ; Organophosphates - blood ; Poisoning - diagnosis ; Poisoning - drug therapy ; Poisoning - mortality ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Severity of Illness Index ; Young Adult</subject><ispartof>Journal of Nepal Medical Association, 2008-04, Vol.47 (170), p.47</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c314t-d8243ec0a60551c912dadc0541c1b6bd0df91f4559bc318fb9b550ca2fbef9023</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18709030$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rehiman, S</creatorcontrib><creatorcontrib>Lohani, S P</creatorcontrib><creatorcontrib>Bhattarai, M C</creatorcontrib><title>Correlation of serum cholinesterase level, clinical score at presentation and severity of organophosphorous poisoning</title><title>Journal of Nepal Medical Association</title><addtitle>JNMA J Nepal Med Assoc</addtitle><description>The aim of the study was to correlate between the clinical score described by Peradenya Organophosphorus Poisoning (POP) scale, serum cholinesterase level at presentation and severity of poisoning. Consecutive patients of organophosphorous poisoning attending Bir Hospital from August 2004 to September 2005 were studied. Patients were grouped into mild, moderate and severe poisoning groups according to the POP scale. Fifty patients fulfilled the inclusion criteria. The severity of poisoning directly correlated with serum cholinesterase level (P&lt;0.001). The differences in the mean requirements of atropine on the first day of admission, in the total amount of atropine needed to treat and in the average duration of hospital stay were significant (P&lt;0.05). There were 26% patients in moderate poisoning and only 4% patients in severe poisoning, but a total of 14% of the patients died, indicating that patients with even moderate degree of poisoning had also died. Both the POP scale severity and derangement in serum cholinesterase levels at initial presentation did not correlate with mortality, which could be due to various other co-morbidities and inadvertent stoppage of atropine infusion particularly at night in the wards. The POP scale and serum cholinesterase at presentation appeared useful to assess the severity of poisoning, particularly in terms of higher amount of atropine and prolonged duration of hospital stay. The patients with evidence of moderate and severe degrees of poisoning need close monitoring. Further studies to evaluate the factors likely to cause deaths, particularly by closely monitoring of moderate and severe organophosphorous poisoning in intensive care units, are required to clarify the correlation with mortality.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Atropine - administration &amp; dosage</subject><subject>Cholinesterases - blood</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Muscarinic Antagonists - administration &amp; dosage</subject><subject>Organophosphate Poisoning</subject><subject>Organophosphates - blood</subject><subject>Poisoning - diagnosis</subject><subject>Poisoning - drug therapy</subject><subject>Poisoning - mortality</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Young Adult</subject><issn>0028-2715</issn><issn>1815-672X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpFkU1LxDAQhoMoun4c_AOSq2B1kibb5iiLHwuCFwVvZZJMNUu3KUlX8N9bd0UPw8Dwvs8M8zJ2LuC6FJU0N6t-jdclzPfYTNRCF_NKvu2zGYCsC1kJfcSOc14BKFFpfciORF2BgRJmbLOIKVGHY4g9jy3PlDZr7j5iF3rKIyXMxDv6pO6Ku2kWHHY8u5iI48iHRJn6cefG3k_2T0ph_PpBxfSOfRw-Yp4qxU3mQww59qF_P2UHLXaZzn77CXu9v3tZPBZPzw_Lxe1T4UqhxsLXUpXkAOegtXBGSI_egVbCCTu3HnxrRKu0NnYy1K01VmtwKFtLrQFZnrDljusjrpohhTWmryZiaLaD6cIG0xhcR42vvbRq2miUV7UDa1ErtEYpqEltWZc7lksx50TtH09As42h-YmhmWKYtBc77bCxa_L_yt-_l9_tdobK</recordid><startdate>200804</startdate><enddate>200804</enddate><creator>Rehiman, S</creator><creator>Lohani, S P</creator><creator>Bhattarai, M C</creator><general>Nepal Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>DOA</scope></search><sort><creationdate>200804</creationdate><title>Correlation of serum cholinesterase level, clinical score at presentation and severity of organophosphorous poisoning</title><author>Rehiman, S ; Lohani, S P ; Bhattarai, M C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c314t-d8243ec0a60551c912dadc0541c1b6bd0df91f4559bc318fb9b550ca2fbef9023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Atropine - administration &amp; dosage</topic><topic>Cholinesterases - blood</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Muscarinic Antagonists - administration &amp; dosage</topic><topic>Organophosphate Poisoning</topic><topic>Organophosphates - blood</topic><topic>Poisoning - diagnosis</topic><topic>Poisoning - drug therapy</topic><topic>Poisoning - mortality</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rehiman, S</creatorcontrib><creatorcontrib>Lohani, S P</creatorcontrib><creatorcontrib>Bhattarai, M C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of Nepal Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rehiman, S</au><au>Lohani, S P</au><au>Bhattarai, M C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlation of serum cholinesterase level, clinical score at presentation and severity of organophosphorous poisoning</atitle><jtitle>Journal of Nepal Medical Association</jtitle><addtitle>JNMA J Nepal Med Assoc</addtitle><date>2008-04</date><risdate>2008</risdate><volume>47</volume><issue>170</issue><spage>47</spage><pages>47-</pages><issn>0028-2715</issn><eissn>1815-672X</eissn><abstract>The aim of the study was to correlate between the clinical score described by Peradenya Organophosphorus Poisoning (POP) scale, serum cholinesterase level at presentation and severity of poisoning. Consecutive patients of organophosphorous poisoning attending Bir Hospital from August 2004 to September 2005 were studied. Patients were grouped into mild, moderate and severe poisoning groups according to the POP scale. Fifty patients fulfilled the inclusion criteria. The severity of poisoning directly correlated with serum cholinesterase level (P&lt;0.001). The differences in the mean requirements of atropine on the first day of admission, in the total amount of atropine needed to treat and in the average duration of hospital stay were significant (P&lt;0.05). There were 26% patients in moderate poisoning and only 4% patients in severe poisoning, but a total of 14% of the patients died, indicating that patients with even moderate degree of poisoning had also died. Both the POP scale severity and derangement in serum cholinesterase levels at initial presentation did not correlate with mortality, which could be due to various other co-morbidities and inadvertent stoppage of atropine infusion particularly at night in the wards. The POP scale and serum cholinesterase at presentation appeared useful to assess the severity of poisoning, particularly in terms of higher amount of atropine and prolonged duration of hospital stay. The patients with evidence of moderate and severe degrees of poisoning need close monitoring. Further studies to evaluate the factors likely to cause deaths, particularly by closely monitoring of moderate and severe organophosphorous poisoning in intensive care units, are required to clarify the correlation with mortality.</abstract><cop>Nepal</cop><pub>Nepal Medical Association</pub><pmid>18709030</pmid><doi>10.31729/jnma.306</doi><oa>free_for_read</oa></addata></record>
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source IngentaConnect Journals
subjects Adolescent
Adult
Aged
Atropine - administration & dosage
Cholinesterases - blood
Female
Humans
Male
Middle Aged
Muscarinic Antagonists - administration & dosage
Organophosphate Poisoning
Organophosphates - blood
Poisoning - diagnosis
Poisoning - drug therapy
Poisoning - mortality
Predictive Value of Tests
Prognosis
Prospective Studies
Severity of Illness Index
Young Adult
title Correlation of serum cholinesterase level, clinical score at presentation and severity of organophosphorous poisoning
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