Correlation between Respiratory Failure and Serum Creatine Phosphokinase Levels in Organophosphate Poisoning

Background: Organophosphate (OP) poisoning is a significant global health issue, particularly in agricultural settings, and is associated with severe toxicity, including respiratory distress, neurological impairment, and, in extreme cases, death. Early prognosis is critical in managing OP poisoning, and biomarkers such as serum creatine phosphokinase (CPK) have been suggested to predict patient outcomes. This study aims to evaluate the role of CPK levels as a prognostic indicator in organophosphate poisoning. Methods: A cross-sectional, prospective study was conducted on 100 patients with pesticide poisoning admitted to Government Theni Medical College & Hospital from April 2020 to April 2021. Demographic, clinical, and laboratory data were collected, and serum CPK levels were measured at admission, 48 hours, and 96 hours. The relationship between CPK levels and patient outcomes (survival or death) was analyzed using statistical tests including Chi-square, t-tests, and ANOVA. Results: Of the 100 patients, 72% were male, and the majority (57%) was aged between 20 and 40 years. The study found a significant association between elevated CPK levels and mortality (p = 0.015 at presentation; p = 0.038 at 48 hours; p = 0.02 at 96 hours). Non-survivors had substantially higher CPK levels, with a mean of 1024.66 IU/L at presentation, compared to 28.68 IU/L in survivors. Additionally, albumin levels were lower in non-survivors (mean 3.16 g/dL vs. 3.94 g/dL in survivors), further suggesting a link between severe poisoning and poor outcomes. Discussion: Elevated serum CPK levels were strongly associated with increased mortality in organophosphate poisoning, likely reflecting muscle injury and systemic toxicity. These findings are consistent with previous studies, supporting the utility of CPK as a prognostic marker. Monitoring CPK levels may provide critical insights into the severity of poisoning and guide treatment decisions, particularly in the early stages of management. Conclusion: This study highlights the potential of CPK levels as an effective prognostic tool in organophosphate poisoning. Elevated CPK levels are significantly correlated with poor outcomes, underscoring the importance of early detection and monitoring. Future prospective studies are needed to refine CPK’s role in clinical practice and establish intervention thresholds for improving patient survival.