SERUM CHOLINESTERASE LEVELS AND MORTALITY PREDICTION IN PESTICIDE POISONING
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Keywords
Pesticide poisoning, organophosphate poisoning, serum cholinesterase, mortality prediction, prognostic marker
Abstract
Background: Acute pesticide poisoning is common medical Emergency in developing nations and has a huge morbidity and mortality. Timely intervention of high-risk patients should be done early and serum cholinesterase has been proposed as a convenient biochemical indication of severity of poisoning.
Objective: To determine the association between serum cholinesterase levels and in-hospital mortality in patients presenting with pesticide poisoning.
Methodology: This was observational study that involved 72 patients who came into the clinic with acute pesticide poisoning in the period from March 2024 to February 2025 at Sir Syed College of Medical Sciences (For Girls) & Khairpur Medical College, Khairpur Mir’s Pakistan. At admission, demographic information, exposure, clinical observations and laboratory values such as cholinesterase levels in serum were taken. Follow up was done to patients until discharge or death. Appropriate statistical tests were used to compare survivors and non-survivors and receiver operating characteristic (ROC) analysis was done to determine the predictive value of serum cholinesterase as a predictor of mortality.
Results: The mortality rate was 27.8%. Non-survivors had significantly lower serum cholinesterase levels, poorer Glasgow Coma Scale scores, and a higher requirement for mechanical ventilation compared to survivors (p<0.001). A serum cholinesterase cutoff value of ≤1500 U/L predicted mortality with high sensitivity and specificity, and ROC analysis demonstrated excellent discriminative ability.
Conclusion: Serum cholinesterase level is a strong predictor of mortality in pesticide poisoning. Early estimation can assist in risk stratification and guide prompt intensive management.
References
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Rajesh
Associate Professor of Medicine, Sir Syed College of Medical Sciences (for Girls), Karachi, Pakistan
Vinod Kumar
Assistant Professor of Medicine, Sir Syed College of Medical Sciences (for Girls), Karachi, Pakistan
Hina Rukhsar
Assistant Professor Forensic Medicine & Toxicology Department, Khairpur Medical College, Khairpur Mir's, Pakistan
Shabeeta Bai
Assistant Professor of Pediatric Nephrology, Sindh Institute of Child Health and Neonatology, Karachi, Pakistan.
