Leucocytic Count and Serum Acetylcholinesterase Level as Predictors of Acute Organophosphate Poisoning (A prospective study)

Background: The widely use of organophosphate compounds (OPCs) is considered a major health problem and presence of an available marker is vital. Aim of the study: To improve the outcome of organophosphate poisoning patients using leucocytic count as a prognostic marker.Methods: A prospective cross-sectional study was done on 88 acutely organophosphate poisoning (AOPP) cases admitted to Poison Control Center Ain Shams University Hospitals (PCC-ASUHs) from August2021 till February 2022. Diagnosis was based on history, clinical manifestations of AOPP, low acetylcholine esterase enzyme (AChE) level and total leucocytic count. Additionally, patients were classified according to Peradeniya Organophosphorus poisoning (POP) score into mild, moderate and severe groups. Assessment of the prognostic value of leucocytic count measured on admission is done to predict the severity and outcome in AOPP. Results: There was a significant association between leucocytic count and severity of poisoning. Also, leucocytic count values showed a sensitivity of 60% and specificity of 50%, if counts were more than 11,000; 40% sensitivity and 56% specificity if counts were more than 12,000; also 15% sensitivity and 92% specificity, if counts were more than 20,000 in predicting mortality in AOPP but there was no significant difference in the mean leucocytic count between survivors and non-survivors. Conclusion: leucocytic count is a useful and easily accessible parameter. Its moderate ability to differentiate between patients with and without severe poisoning suggests that it may be used in conjunction with clinical signs in assessment of AOPP in centers where measurement of AChE is absent.