Study of Prognostic Significance of Serum Levels of Creatine Kinase in OPP. Importance of Elevated Serum Amylase in Patients of Organophosphorus Compound Poisoning

Background: Organophosphate poisoning is a ever increasing and troublesome situation in the developing countries and is a major health care challenge in the 21st century. Organophosphates are extremely toxic chemicals which present with a myriad of clinical problems all of which lead to difficulties in determining management. The organophosphates are an extremely toxic group of compounds which are rapidly absorbed by the dermal and oral routes. Following significant exposure symptoms of toxicity generally occur within 4 hours. Aim: Study of prognostic significance of serum levels of Creatine kinase in OPP. Importance of elevated serum amylase in patients of organophosphorus compound poisoning. Method: This is a cross sectional study of 50 patients with OP poisoning admitted at government hospital medical ward, Kurnool. The severity of poisoning, important biochemical, clinical parameters were measured. Serum CPK, serum amylase and serum acetylcholinesterase were collected at admission and during follow-up in all patients. The outcome studied would be survival with or without ventilator assistance and death. Results: Among 50 poisoning patients, 68% being male and 48% aged between 21-40 years. Most patients (76%) were married, and farmers constituted the largest occupational group (34%). Chlorpyrifos and Dimethoate were the most common poisons, accounting for 30% and 28% of cases. In terms of clinical findings, 60% of patients had SpO2 levels above 95%, and 48% had serum Creatine phosphokinase (CPK) levels below 350 U/L, while 26% had CPK levels above 1400 U/L. Serum amylase was normal in 72% of cases, and 56% had elevated plasma acetylcholinesterase (AChE) levels. Ventilator support was needed in 46% of patients, especially those with higher CPK levels. Chi-square tests indicated significant associations between elevated CPK, amylase, and AChE levels with poorer outcomes, including higher mortality. Conclusion: The biochemical marker serum amylase & Creatine kinase is a dependable indicator due to its accessibility, affordability, and ability to forecast the need for intubation and mortality in cases of acute OP-poisoning. Elevated serum amylase & creatine kinase levels reported at admission indicate a worse prognosis and a higher likelihood of death. Therefore, it can serve as an alternative indicator for predicting clinical outcome and prognosis.