Clinical Profile and Prognostic Value of Serum Cholinesterase Levels in Organophosphorus Poisoning

Abstract

Objective: To investigate the clinical profile of organophosphorus poisoning patients with a focus on serum cholinesterase levels and their correlation with clinical severity and treatment outcomes. Methods: This retrospective study analyzed medical records of patients admitted with organophosphorus poisoning at three tertiary care hospitals from January 2019 to December 2023. Inclusion criteria were: (1) confirmed diagnosis of organophosphorus poisoning; (2) serum cholinesterase levels measured at admission; (3) age 18 years or older. Exclusion criteria included incomplete records, secondary causes of cholinesterase inhibition, and patients younger than 18 years. Data on demographics, clinical symptoms, serum cholinesterase levels at admission and after 24 hours, and treatment outcomes were collected and analyzed.

Results: A total of 150 patients were included, with a mean age of 45.2 years. The most common symptoms were muscarinic (80%), followed by nicotinic (60%) and central nervous system (50%) symptoms. Serum cholinesterase levels were significantly lower at admission (mean 320 U/L) and increased to a mean of 600 U/L after 24 hours of treatment. Lower initial serum cholinesterase levels were associated with more severe clinical manifestations. Most patients showed improvement in symptoms following treatment, although some experienced persistent symptoms.

Conclusion: Organophosphorus poisoning manifests with a range of symptoms affecting multiple organ systems. Serum cholinesterase levels are a crucial marker for assessing poisoning severity and guiding treatment. Effective management can significantly improve patient outcomes, but continuous monitoring is essential due to the potential for persistent symptoms. This study highlights the importance of serum cholinesterase measurement in the clinical management of organophosphorus poisoning and suggests areas for future research to optimize treatment protocols.

Keywords: Organophosphorus poisoning, serum cholinesterase, clinical manifestations, treatment outcomes.