The Prognostic Value of the Glasgow Coma Scale, Serum Acetylcholinesterase and Leukocyte Levels in Acute Organophosphorus Poisoning

Cander, Başar; Dur, Ali; Yıldız, Mesut; Koyuncu, Feridun; Girişgin, Abdullah Sadık; Gül, Mehmet; Okumuş, Mehmet

doi:10.5144/0256-4947.2011.163

Cited by 9 publications

(7 citation statements)

References 9 publications

(2 reference statements)

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“…[15] Cander et al showed that GCS values were effective in predicting the outcomes wherein patients with a median GCS of 3 died while all of those with a score of 15 were discharged. [16] In our study, median GCS of patients who died was 6 while the score for those who survived was 15, which is similar to what other studies have shown.…”

Section: Discussionsupporting

confidence: 91%

A retrospective review of intensive care management of organophosphate insecticide poisoning: Single center experience

et al. 2015

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Background: Organophosphate (OP) compounds are used as insecticides. Given the widespread availability and use of these chemicals, OP poisoning is quite common following either accidental or intentional exposures. Immediate intensive care management can save lives in these patients. We aimed to investigate intensive care management provided to OP poisoning patients in a tertiary care hospital in Turkey. Subjects and Methods: This was a retrospective chart review of 62 patients, admitted to the Intensive Care Unit (ICU) with OP poisoning between 2000 and 2012. Results: Of the 62 patients studied, 40 (65%) were male, 45 (73%) were suicide attempts, 59 (95%) ingested the OP compounds, and three patients (5%) (two patients with suicide and 1 with accidental exposure) died in the ICU. There were statistically significant differences between survivors and nonsurvivors for Glasgow Coma Scale (GCS) on admission (P = 0.034), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (P = 0.003), Sequential Organ Failure Assessment (SOFA) score (P = 0.024), time to initiation of treatment (P = 0.034) and serum lactate dehydrogenase (LDH) levels (P = 0.007). Conclusions: Organophosphate poisoning is a life-threatening condition that requires immediate diagnosis and management. GCS, APACHE II score, SOFA score, and time to admission to the emergency department and LDH levels can provide prognostic information and predict outcomes.

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Section: Discussionsupporting

confidence: 91%

A retrospective review of intensive care management of organophosphate insecticide poisoning: Single center experience

et al. 2015

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“…So, it is cardinal to recognize the entire spectrum of the symptoms. Organophosphorus (OP) compounds inhibit acetyl cholinesterase and butyryl cholinesterase enzymes resulting in over stimulation at cholinergic synapses [2]. Symptoms are classified into muscarinic, nicotinic and central depending on the actions over the respective receptors.…”

Section: Introductionmentioning

confidence: 99%

Study of serum cholinesterase, CPK and LDH as prognostic biomarkers in organophosphorus poisoning

2014

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Introduction: Organophosphorus insecticides are arguably one of the commonest causes of morbidity and mortality due to poisoning worldwide, especially in developing countries like India due to its easy availability. This study was conducted to estimate the levels of Serum Cholinesterase, Serum Creatinine Phosphokinase & Serum Lactate Dehydrogenase on admission for correlation with severity of organophosphate poisoning and to reevaluate their levels on Day 4 and Day 8 and correlate them with the complications and final outcome of the poisoning. Material and methods: This is a single centered cross sectional study over a period of one year.100 patients of OP poisoning were selected and their clinical severity was categorized according to Peradeniya organophosphorus poisoning (POP) scale. Level of serum Cholinesterase, serum CPK, and serum LDH were measured at admission and on Days 4 and 8. Results: Serum Cholinesterase and CPK levels strongly correlated with clinical severity. The comparative values of serum Cholinesterase and serum LDH amongst survivors and non survivors during the course of the study was not statistically significant. The comparative values of serum Creatinine Phosphokinase between survivors and non survivors showed a statistically significant difference. Conclusion: Serum Cholinesterase serves as a diagnostic parameter for organophosphorus poisoning and correlates with the severity but it cannot be used as a prognostic biomarker. Serum Creatinine Phosphokinase shows a strong degree of positive correlation with the severity of poisoning and can be used as a predictor of outcome in organophosphorus poisoning.

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“…They also found that the death rate was 21.9% and only GCS correctly predicted a similar death rate among OPP patients. 14 In this regard, the serial assessment of pseudo cholinesterase levels is an option but it is extremely expensive. And unavailability in many centers.…”

Section: Discussionmentioning

confidence: 99%

Mortality among organophosphate poisoning patients presenting with low Glasgow coma scale score at A Tertiary Care Hospital.

Ali

Kumar

Ahmed

et al. 2020

TPMJ

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This study is designed to assess the mortality in OPP patients with low GCS scores. Study Design: Cross Sectional study. Setting: Jinnah Postgraduate Medical Center. Period: From 1st February 2018 to 31st August 2018. Material & Methods: Included patients with low GCS, both genders and age of 18-60 years diagnosed with OPP. Their GCS was calculated and the outcome was determined in terms of mortality. Results: Out of 70 patients, the mean age was 35.2+16.5 years with the majority (62.9%) <30 years. 62.9% of these were males. Most (57.1%) of them presented after ingestion of <15mL of OP, 60% had the poisoning for >60 minutes, and the majority (74.3%) had taken it orally. When the GCS was computed, 81.40% had that of >5, while the mean came out to be 6.64 ±1.43. The mortality rate here was 17.10%. Conclusion: GCS toll can be a helpful and practical tool in assessing the mortality among the patients of OPP. However, because of the limited literature on the subject further studies are recommended to improve its validity.

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The Prognostic Value of the Glasgow Coma Scale, Serum Acetylcholinesterase and Leukocyte Levels in Acute Organophosphorus Poisoning

Cited by 9 publications

References 9 publications

A retrospective review of intensive care management of organophosphate insecticide poisoning: Single center experience

A retrospective review of intensive care management of organophosphate insecticide poisoning: Single center experience

Study of serum cholinesterase, CPK and LDH as prognostic biomarkers in organophosphorus poisoning

Mortality among organophosphate poisoning patients presenting with low Glasgow coma scale score at A Tertiary Care Hospital.

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