Correlation of Serum Amylase, Lipase, and Creatine Kinase with Severity of Organophosphate Poisoning- A Cohort StudyCorrespondence Address :
Dr. Pranay Kumar Patro,
Flat No.3c, Nilamani Enclave, Professor Pada, Cuttack, Odisha, India.
Introduction: Organophosphate Compounds (OP) are widely used pesticides in agriculture. It is easily available and OP poisoning is most common cause of poisoning and hospital admissions. Severe poisoning is associated with high mortality. Severity of poisoning can be assessed by Peradeniya Organophosphorus Poisoning (POP) scale, Acute Physiology and chronic Health Evaluation (APACHE) II, Glasgow Coma Scale (GCS) or serum Cholinesterase Level (ChE). Serum amylase, lipase, and creatine kinase are important biomarkers raised in OP poisoning.
Aim: The aim of the study is to correlate serum amylase, lipase, and creatine kinase with severity of OP poisoning.
Materials and Methods: This was a hospital based observational cohort study conducted on 130 patients of organophosphate poisoning admitted in general medicine wards of SCB Medical college Cuttack, Odisha from April 2019 to December 2020. Serum Acetylcholine Esterase (AChE), amylase, lipase and creatinine Kinase were estimated at admission, day 2, and at discharge. Other routine investigations were done. Acetylcholine Esterase (AChE) was used to confirm the diagnosis. The severity of poisoning was assessed using POP scale and graded as mild, moderate and severe. The severity of poisoning and the level of enzymes were correlated. The parameters were tabulated and mean values and Standard Deviation (SD) were analysed using Statistical Package For The Social Sciences (SPSS) software.
Results: Out of 130 patients 91 were males and 39 were females, mostly from rural areas, both farming and non-farming community. Age ranged from 14 years to 78 years, with majority in 18 to 38 years. AChE decreased in all cases depending on severity confirming OP poisoning. Severity as assessed by POP score were mild (52 patients), moderate (46 patients) and severe (32 patients). At admission, the Amylase (U/L), Lipase (U/L), and Creatine kinase (U/L) level (mean±SD) were in mild poisoning 83.7±41.9 U, 70.9±18.6, 72.5 ±34.9, in moderate poisoning 153.6±143.8, 91.9±47.4, 92.6±81.5, and in severe poisoning 243.9±143.8, 195.3±147.7, 298.8±207.4, respectively. Measurements on second day also remained elevated. Among the severe cases twenty four patients developed Intermediate Syndrome (IMS), and twenty six patients died. There was positive correlation between increase of enzyme levels and the severity of OP poisoning as per POP score.
Conclusion: Serum amylase, lipase, and creatine kinase level correlated well with the severity of organophosphorus poisoning and scan be used additionally as an indicator to assess the severity. Serum amylase is a better indicator of severity than lipase and Creatine Kinase (CPK).
Insecticide, Intermediate syndrome, Serum cholinesterase, Severity scale
Date of Submission: Apr 18, 2021
Date of Peer Review: May 04, 2021
Date of Acceptance: Jun 24, 2021
Date of Publishing: Jul 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)