The relationship between electrocardiographic changes, cholinesterase levels and mortality in acute organophosphate poisoning

Aim: In our study we aimed to investigate the relationship between electrocardiographic (ECG) changes, cholinesterase levels and mortality due to acute organophosphate poisoning. Material and Methods: We planned to take patients who administered to emergency department with organic phosphorus poisoning randomized and prospectively for 2 years between 01.08.2009 31.08.2011 after approval by the Ethics Committee. The electrocardiograms of the patients were taken after admission to the emergency department, before the treatment (atropine and pralidoxime application). Blood samples were taken and studied in the laboratory of our hospital. ECG findings, cholinesterase values and the final situation of the patients were recorded at the standard data entry form. SPSS 18.0 package program was used for statistical analysis of data. The statistical significance level of all tests was p < 0.05. Results: The five of thirty nine patients (12.8 %) included in the study have died during the treatment. The electrocardiographic findings seen in patients in order of frequency; sinus tachycardia (48.7 %), prolonged QT interval (20.5 %), and right bundle branch block (20.5 %), ST-T wave changes (12.8 %), atrial fibrillation (7.7 %), right axis deviation (5.1 %), prolonged PR (2.5 %). There was no statistically significant difference between the ECG findings of the patient groups who died or discharged (p ≥ 0.05). The mean serum cholinesterase levels of the patients who died were statistically lower than the discharged patients (p = 0.006). Conclusion: There is not a significant relationship between ECG findings and the severity of organophosphate poisoning.There is a statistically significant relationship between mortality and low levels of serum cholinesterase due to severe poisoning. ECG findings and their effects to the mortality in organophosphate poisoning can give an opinion to the emergency physicians and contribute to their clinical experiences. However, more detailed studies are needed in this matter. [Cukurova Med J 2013; 38(2.000): 181-188]