Study of clinical profile and comparison of plasma cholinesterase level with severity scoring system (Peradeniya Organophosphorus Poisoning score) in Organophosphate poisoning

Chiragkumar D Patel, Snehal R Patel, Priyanka D Patel

Abstract


Background: OP poisoning occurs in various state occupational exposures during working in farm and pest control, during their manufacturing, storage and transport. There is limited availability of facilities and resources at peripheral centers in developing countries all OP poisoning patients are difficult to manage. Hence it important to know the clinical features and other factors that indicates the severity of poisoning and criteria to speculate the need for early referral which should be identified in the initial examination. 
Objectives: To study clinical profile of patients presented with Organophosphate poisoning and also to correlate plasma cholinesterase level and the clinical criteria score described by the Peradeniya Organophosphorus Poisoning (POP) score at initial presentation and the severity of poisoning.
Methods and Materials: A prospective observational study after Institutional Ethics Committee permission. The diagnosis was made based on history or evidence of exposure to OP compound. Plasma cholinesterase level was done at the time of admission. Clinical severity was assessed and categorized
according to Peradeniya OP Poisoning (POP) score. All the collected data were analyzed using appropriate statistical test.
Observations: Demographic distribution showed incidence of OP poisoning was high (59%) in 21 – 30 years of age group, low socioeconomic class (66%), and Agriculture field workers (39%). Among all patients 81% had suicidal exposure and 88% had ingestion orally. 30% patients were poisoned by monocrotophos. 25 % of patients found plasma cholinesterase level <10%. Severity of OP poisoning according to Peradeniya OP score showed 24% of patients fall into severe category with mortality incidence of 58.3%.
Conclusion: Both the plasma cholinesterase level and POP score are an important tools for the diagnosis of the severity of OP poisoning. As the facility for estimation of plasma cholinesterase is not available in all peripheral centers of India, POP score can be used to describe the severity of OP poisoning.

Keywords: Organophosphate compound poisoning, Plasma Cholinesterase, Peradeniya OP Poisoning (POP) score.


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