A Study of Correlation of CPK MB Levels with Prognosis in Organophosphorous Poisoning

Background: Organophosphorus compound (OPC) poisoning remains a significant public health concern, particularly in developing countries. Early identification of prognostic indicators is essential for improving clinical outcomes. The objective is to evaluate demographic characteristics, clinical severity, electrocardiographic changes, and cardiac enzyme levels in patients with OPC poisoning and to assess their association with functional outcomes. Material and Methods: This prospective observational study included 217 patients presenting with OPC poisoning to the Department of General Medicine, District Hospital, Tumakuru, Karnataka, over an 18-month period (February 2019 to August 2020). Data on demographics, Peradeniya Organophosphorus Poisoning (POP) score, ECG findings, pseudocholinesterase, and CPK-MB levels were collected and analyzed in relation to ICU stay and clinical outcomes. Results: The majority of patients were aged <30 years, with male predominance. Most cases were mild (53.92%), followed by moderate and severe poisoning. QT prolongation was the most common ECG abnormality and showed a significant association with severity and adverse outcomes. Pseudocholinesterase levels increased, while CPK-MB levels decreased over time, both demonstrating significant trends (p<0.001). Cardiac enzyme levels correlated with severity, ICU stay, and mortality. The overall recovery rate was 90.32%, with a mortality rate of 9.68%. Conclusion: QT prolongation and cardiac biomarkers, particularly CPK-MB, serve as important prognostic indicators in OPC poisoning. Their integration into clinical assessment may improve risk stratification and patient management. Further studies are warranted to validate these findings.

Keywords: Organophosphorus poisoning, QT prolongation, CPK-MB, pseudocholinesterase, prognosis, POP score.