A STUDY OF RED CELL DISTRIBUTION WIDTH AND SERUM CHOLINESTERASE LEVELS ON ADMISSION AS A PROGNOSTIC MARKER IN ORGANOPHOSPHORUS COMPOUND POISONING

Abstract

Introduction:
Organo-phosphates are widely used in horticulture and agriculture in developing countries and therefore poisoning with these agents is common either by unintentional or suicidal ingestion. In developing countries like India, it is still a major public health problem because of its association with high morbidity and mortality. Organo-phosphates may cause deformation of erythrocyte membranes by acute and chronic inflammation. Hence, it is expected that Red cell distribution width (RDW) levels may be increased in
Organophosphorus (OP) poisoning and can thus aid in prognosis. Objectives:
1. To assess red cell distribution width and serum cholienesterase levels on admission.
2. To assess correlation between red cell distribution width and outcome in organophosphorus poisoning.
Methodology:
A prospective interventional study was conducted among 100 Organophosphorus poisoning cases admitted in our hospital. A detailed history was obtained using a pre-designed, structured proforma followed by a detailed systemic examination. Relevant investigations were conducted which included red cell distribution width. Chi-square test was used to assess the relation between red cell distribution width and outcome in organophosphorus poisoning.

Results:
Among 100 participants, majority were males (65%) and between 21-30 years age group (43%). Most common compounds involved in poisoning wereMonocrotophos (36%) Chlorpyrifos (34%), Duration of exposure for 69% of them was 1-2 hours. 50% of them had
RDW ≤ 13 and 50% had RDW > 13. There were 6 deaths among 50 subjects with RDW >13 and only 1 death among 50 subjects with RDW ≤ 13 and this difference was statistically significant (P<0.05).
Conclusion:
In this study RDW was significantly associated with outcome and served in assessing the outcome in OP poisoning. We conclude that RDW is simple test which can be measured easily at the time of admission and used as a predictor of outcome in OP poisoning.