An Observational Study on Serum Amylase and CPK Levels as Predictors for Ventilatory Support and Mortality in Cases of OPC Poisoning

Organophosphorus compound (OPC) poisoning is a common medical emergency in India and is associated with significant morbidity and mortality. Respiratory failure is the major cause of death and many patients require ICU admission and mechanical ventilation. Early identification of patients who are likely to require ventilatory support is important for timely intervention and better resource allocation.

Serum cholinesterase is useful for diagnosis but has limitations as a prognostic marker due to variable baseline levels and inconsistent correlation with clinical severity. Serum creatine phosphokinase (CPK) and serum amylase are simple, inexpensive and widely available investigations which may reflect the severity of poisoning. CPK rises due to sustained muscle fasciculations and neuromuscular injury, while serum amylase may rise due to autonomic dysfunction and pancreatic involvement.

This hospital based prospective observational cohort study will be conducted in the Emergency Department of Jawaharlal Nehru Medical College and Associated Group of Hospitals, Ajmer, over a period of 12 months. A total of 100 adult patients with acute OPC poisoning presenting within 24 hours and having features of cholinergic toxidrome will be included after informed consent.

Serum CPK and serum amylase levels will be measured at admission before atropinization. Clinical severity will be assessed using the Peradeniya Organophosphorus Poisoning (POP) scale. Patients will be followed during hospital stay to assess requirement of mechanical ventilation and clinical outcome including mortality and duration of ICU stay.

The study aims to evaluate serum CPK and serum amylase as prognostic biomarkers for ventilatory support and mortality in OPC poisoning and to assess their correlation with severity of poisoning.