Emergency Laboratory Abnormalities in Suicidal Patients with Acute Organophosphate Poisoning

Abstract

Purpose: Organophosphate poisoning may cause the life-threatening events resulted in different organ failure. The aim of this study was to evaluate the relationship between laboratory parameters and the degree of intoxication in patients attempted to suicide using organophosphate admitted to the emergency department. Material and methods: Ninety-one patients who attempted to suicide with acute organophosphate poisoning admitted to the emergency service were included in this retrospective study. The initial laboratory findings and clinical status of patients were evaluated. Clinical severity of patients was also graded according to the Bardin classification on admission. Results: Oral ingestion was found to be the most common route of poisoning for suicidal purpose. Serum cholinesterase activity was measured significantly depressed in the grade 1, 2 and 3. Leukocyte counts, glucose and amylase levels were significantly higher in the grade 1 and 2, but they were considerably elevated in the grade 3 compared to normal reference. Acute renal failure and pancreatitis were observed on following admission in some patients of grade 2 and 3. Six patients were died in these grades. Conclusions: The marked decrease of serum cholinesterase activity appears to be associated with clinical severity in patients with acute organophosphate intoxication. However, it must be interpreted carefully due to intake of different organophosphate and the amount of exposure. Hyperglycemia, hyperamylasemia and leukocytosis can arise frequently in patients of grade 2 and 3.