Prognostic significance of creatine phospokinase (CPK) levels in assessing the severity of organo phosphorus compound poisoning

 

 

Abstract              Background: OP toxicity is important global health problem especially in many developing countries. Acute pesticides exposure can be accident or suicide, occupational, bystander exposure, or exposure because of consumption of food items containing pesticide residues. Estimation of CPK is economical and levels are increased both in acute as well as in intermediate syndrome and can be used as a low budget, easily available prognostic marker for acute organophosphorus poisoning. Present study was aimed to assess prognostic significance of creatine phospokinase (CPK) levels in assessing the severity of organophosphorus poisoning compound poisoning. Material and Methods: This hospital based prospective, observational study conducted in cases of acute organophosphorus poisoning admitted to our hospital within 12 hours of consumption of the poison, >12 years age. Results: The majority of cases 139 (65%) were between the age group 20 to 40 years. The incidence of organophosphorus poisoning was more in males (137 patients, 64%) when compared to females (77 patients, 36%). The severity of the OPC poisoning was assessed clinically by Peradeniya Organophosphorus Poisoning (POP) scale. In the present study the mild form (51%) of OP poisoning was most common followed by moderate (29%) and severe form (18%). The CPK levels were much lower in the patients who had completely recovered when compared to the patients who had died and the difference in the levels were found to be statistically significant (p<.001). The CPK levels can be considered as a prognostic indicator in the patients who had consumed OPC poison. We noted a very strong negative correlation between serum CPK and serum acetylcholinesterase. Conclusion: Serum phosphokinase level has proved its efficacy as a prognosis marker in OP poisoning cases. It is cheap, easily available, especially in developing countries where EChE and BChE levels are not widely available in most of the laboratories.

Key Words: organophosphorus poisoning, serum cholinesterase, serum Creatine phosphokinase, severity, correlation.