TY  - JOUR
T1  - Serum Creatine Phosphokinase Levels as Prognostic Biomarker in Organophosphate Poisoning in A Tertiary Care Hospital
AU - Sudeshna, Gajula AU - Gatla, Vamshi AU - Alekhya, Patchava AU - Mohan, K. 
JO  - Research Journal of Medical Sciences
VL  - 18
IS  - 12
SP  - 944
EP  - 952
PY  - 2024
DA  - 2001/08/19
SN  - 1815-9346
DO  - makrjms.2024.12.944.952
UR  - https://makhillpublications.co/view-article.php?doi=makrjms.2024.12.944.952
KW  - Creatine phosphokinase
KW  - organophosphorus poisoning
AB  - Organophosphates (OPs) are a diverse group of chemical compounds
formed by esterifying phosphoric acid with alcohol. Common uses for
these compounds include insecticides, herbicides, and nerve agents in
chemical warfare. This study aims to determine the prognostic value of
serum CPK levels in OP poisoning and compare its predictive accuracy
with the POP Scale. By integrating biochemical markers with clinical
evaluation, the study seeks to improve early risk stratification, ensuring
that high‐risk patients receive timely and appropriate medical attention.
This was a prospective observational study conducted in the Department
of General Medicine at PESIMSR Hospital over a period of 18 months. The
study population consisted of patients admitted with organophosphate
poisoning during the study period. Patients were selected using a
purposive sampling technique. Based on the study conducted by
Bhattacharyya K. et al., the required sample size was estimated to be 100,
and therefore, a total of 100 patients were included in the study. Patients
were eligible for inclusion if they had a history of exposure to an
organophosphorous compound and were above 18 years of age. A total
of 59 participants (61.5%) required ventilator support, while 37
participants (38.5%) did not, indicating that a significant proportion of the
study population experienced respiratory compromise necessitating
mechanical ventilation. the association between the presence of
intermediate syndrome and the severity of poisoning based on the POP
score among the study participants (N=96). None of the participants with
mild POP scores developed intermediate syndrome, while 6 participants
(13.0%) with moderate scores and 10 participants (55.6%) with severe
scores did. This study shows that the POP score, which measures
organophosphate poisoning severity, is linked to biochemical markers,
clinical outcomes, and sequelae. A substantial fall in serum
pseudocholinesterase and a gradual increase in CPK were related to
increased poisoning severity, ventilator support, intermediate syndrome,
and fatality. All deaths were serious, emphasising the necessity for quick
risk assessment. High CPK levels predicted respiratory failure and poor
clinical prognosis, while low pseudocholinesterase levels predicted
intermediate syndrome and death.
ER  -