The difference in C-reactive protein value between initial and 24 hours follow-up (D-CRP) data as a predictor of mortality in organophosphate poisoned patients

Abstract

Background. Organophosphate poisoning is a worldwide concern and there have been many reports about factors involved in the severity and prognosis of toxicity. The aim of this study was to evaluate the relationship between the serum C-reactive protein activity and clinical outcome in acute organophosphate-poisoned patients. Methods. This was a retrospective cohort study conducted from January 2007 to February 2012. Using a multivariate logistic analysis, data on the total population was retrospectively analyzed for association with mortality. The difference in C-reactive protein value between initial and follow-up after 24 hours (D-CRP) was compared in survivors and non-survivors. The D-CRP, APACHE (Acute Physiology and Chronic Health Evaluation) II scoring system and SOFA (Sequential Organ Failure Assessment) score were compared by analyzing receiver operating characteristic (ROC) curves. Results. Among the 96 subjects, 74 survived and 22 died. In the total population, age, BUN, creatinine, APACHE II and SOFA score, MAP, GCS, hematocrit, respiratory rate, albumin, cholinesterase, and the difference in C-reactive protein value between initial and follow-up after 24 hours (D-CRP) were found to be associated with mortality. The fatality rate of organophosphate poisoning was 22.9% and the D-CRP was found to be associated with a significantly higher risk of death in a multiple logistic regression (Odds ratio = 1.178, 95% CI = 1.049–1.322, p = 0.006). Conclusion. The initial serum C-reactive protein and acetylcholinesterase were not found to be associated with the severity of acute organophosphate poisoning. However, the difference in C-reactive protein value between initial and follow-up after 24 hours (D-CRP) was associated with mortality in the total population of patients with acute organophosphate poisoning.

Keywords:

• Metabolic
• Perfusion
• Respiratory support