The Prognostic Value of the C-reactive Protein Levels in Acute Organophosphate Poisoning

ABSTRACT

PURPOSE: Organophosphate poisoning is a worldwide concern and there have been many reports describing the factors affecting the severity and prognosis resulting from its toxicity. This study aims to investigate if C-reactive protein is a useful independent predictor of mortality in organophosphate poisoning patients. METHODS: This retrospective study targeted organophosphate intoxication patients who were admitted to the emergency department of Samsung Changwon Hospital from January 1st, 2006 to December 31st, 2010. The data was retrospectively collected from clinical records and laboratory files, and using multivariate logistic analysis, the total population data was retrospectively analyzed for its association with mortality. RESULTS: A total of 70 patients were enrolled in this study. Of the 70, 53 survived and 17 died. Significant clinical factors such as age, mean arterial pressure, Glasgow coma scale score, respiratory rate, PaO2/FiO2, hematocrit, albumin, glucose and C-reactive protein (measured 24 hours after admission) were associated with mortality. The fatality rate resulting from organophosphate poisoning was 24.3%, and there was an increase observed in the mortality rate of patients with higher C-reactive protein at 24 hours after admission. CONCLUSION: The initial serum C-reactive protein and acetylcholinesterase results had no significant association with the severity of acute organophosphate poisoning. However, C-reactive protein results after 24 hours were significant independent predictors of mortality in the total population of patients afflicted with acute organophosphate poisoning.