Evaluating the relationship between the serum acetylcholinesterase level and the clinical course and mortality in patients who present to the university hospital emergency department with organophosphate toxicity

.OBJECTIVESThe aim of this study is to evaluate the relationship between the serum acetylcholinesterase (AChE) level and the clinical course and mortality in patients who presented to the university hospital emergency department with organophosphate and carbamate toxicity.METHODSAll patients who presented to the hospital emergency department with organophosphate and carbamate toxicity between 1 June 1993 ile 31 June 2007 were included in this retrospective analitic study. Demographic characteristics, type of toxic agent, route and reason for the exposure, clinical signs and findings, serum AChE levels, mechanical ventilation requirements, complications that developed and outcome of the patients were analized.RESULTSA total of 108 patients were included in this study. The mean age was 34.1±18.6 and the male/female ratio was 1.57. The mean serum AChE level in the patients who required mechanical ventilaton was significantly lower according to the patients who did not (1103.90 ± 1718.92, 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, 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 (637.50 ± 502.55, 3369.46 ± 3562.56 IU/L, p<0.01, respectively).CONCLUSIONOur 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 risk assessment in organophosphate and carbamate intoxicationKEY WORDSOrganophosphate and carbamate intoxications, acetylcholineesterase