Evaluating the relationship between serum acetylcholinesterase levels and clinical course and mortality of patients presented with organophosphate and carbamate posinings

Abstract

Objectives: The aim of this study was to evaluate the relationship between the serum acetylcholinesterase (AChE) levels and the clinical course and mortality of patients presented with organophosphate and carbamate toxicity.
Materials and Methods: All patients presented to the Emergency Department of Dokuz Eylül University Hospital with organophosphate and carbamate toxicity between 1 June 1993 ile 31 June 2007 were included in this retrospective, cross sectional and analitic study. Demographic characteristics, type of toxic agent, reason for the exposure, clinical signs and findings, serum AChE levels, mechanical ventilation requirements, complications that developed and outcome of the patients were analized. The study data were recorded to a standart study form and a database fort the analysis.
Results: A total of 108 patients were included in this study. 13.9% (n=15) of the study patients were children and 86.1% (n=93) were adult. The mean age was 34.1±18.6 and the male/female ratio was 1.57. The meanAChE levels of all study patients was 3167±3503 IU/L (min-max: 31- 13685 IU/L). The mean serum AChE level in the patients required mechanical ventilaton was significantly lower according to the patients who did not (1103.90±1718.92 vs 3843.55±3680.44 IU/L, p<0.01, respectively). The mean serum AChE level in the patients who developed complications was significantly lower according to the patients who did not (735.66±985.81 vs 3589.95±3613.61 IU/L, p<0.01, respectively). The mean serum AChE level of the patients who died was significantly lower according to the survival group (637.5±502.55 vs 3369.46±3562.56 IU/L, p<0.01, respectively).
Conclusion: Our results indicate that lower serum AChE levels are associated with higher risk of inhospital mortality and complicated clinical course in organophosphate and carbamate toxicity. The serum AChE level may be used as a valuable parameter in evaluating the clinical course and mortality in patients with organophosphate and carbamate intoxication.