Correlation of Serum Amylase and Serum Lipase Levels with Clinical Outcome in Acute Organophosphorus Poisoning

Abstract

Background: Organophosphorus (OP) compounds, widely utilized as agricultural pesticides, are a major global cause of poisoning, particularly in developing nations. Their toxicity stems from irreversible inhibition of acetylcholinesterase, leading to excessive cholinergic stimulation and high morbidity and mortality. While plasma cholinesterase remains the diagnostic gold standard, its practical limitations highlight the need for alternative prognostic markers. This study investigates the utility of serum amylase and serum lipase in this context.

Objectives: The primary objective was to correlate the clinical severity of OP poisoning with serum amylase and serum lipase levels. Secondary objectives included assessing their association with complications, duration of hospital and ICU stays, and mortality rates.

Methods: This was a cross-sectional study conducted over 18 months at Adichuchanagiri Hospital and Research Centre. A total of 138 patients with acute OP poisoning were enrolled. The severity of poisoning was classified as mild, moderate, or severe using the Peradeniya Organophosphorus Poisoning (POP) scale. Serum amylase and lipase levels, along with other routine laboratory investigations, were measured. Statistical analysis was performed using SPSS version 26, with a p-value of < 0.05 considered significant.

Results: The study population was predominantly male (74.64%), with a high incidence of intentional poisoning (87.68%). Methyl parathion was the most common ingested compound (44.93%). Moderate poisoning was observed in 64.49% of patients, and severe cases in 23.19%. Statistically significant associations were found between elevated serum amylase and lipase levels and severe poisoning (p < 0.05), prolonged ICU stay, and higher mortality rates.

Conclusion: Serum amylase and serum lipase are valuable and easily accessible prognostic markers for acute OP poisoning. Their elevated levels correlate significantly with increased disease severity, prolonged hospitalization, and higher mortality. The routine estimation of these enzymes can aid in early risk stratification, facilitating timely and targeted clinical management to improve patient outcomes.