Evaluation of The Role of Cortisol, Glycemic state and Poison severity score in Prognosis of Acute Organophosphate Poisoning

Background: Organophosphate Poisoning (OP) is a worldwide health problem , early evaluation of cases using scores, metabolic and hormonal changes is mandatory for predicting prognosis and outcome. Little reports were found on this subject before at Zagazig university hospital. So we aimed to assess the prognosis of cases with acute organophosphorus compounds poisoning in order to improve the course of management. Methods: This was a prospective cohort study included 52 cases of acute organophosphorus poisoning presented to the poison control center (PCC) and intensive care units (ICU) of Zagazig University Hospitals. Cortisol, glycemic state and poison severity score (PSS) were measured in all cases. Results: Serum cortisol on admission, 6 and 12 hours was highly significantly related to poisoning severity and intensive care unit (ICU) admission. Specifically, its measurement at 6 hours was the best in prediction of severity and the need for ICU with 87.8% Specificity. Random blood sugar (RBS) on admission and discharge was highly significantly related to poisoning severity and ICU admission. Specifically, its measurement on admission was the best in prediction of severity and the need for ICU with 92.7% Specificity. According to PSS, 15.4 % of cases were grade 3 (sever grade) that were highly significantly related to the need for ICU admission with 100% specificity. Conclusion: PSS, RBS (on admission) and Cortisol (6 hrs) respectively are good predictors for poisoning severity and need for ICU admission in acute organophosphate poisoning.