A study of serum albumin and serum ferritin level in organophosphorus poisoning as a prognostic marker and its correlation with severity and outcome

Introduction: In developing countries poisoning is a common method of suicide. OPC poisoning either suicidal (intentional self-poisoning) or accidental is a significant health hazard in developing countries like India. Various biochemical markers correlates with severity and outcome in OPC poisoning, helps in determine prognosis and effective treatment strategy. Material and Methods: This was a hospital-based cross-sectional study. We studied 100 patients of OPC poisoning admitted in medicine wards confirmed by history, examination and circumstantial evidence of ingestion. Patients were classified into 3 categories based on severity according to POPS scale: Mild (score 0-3), Moderate (score 4-7), Severe (score 8-11). Patients were also classified into 2 categories based on clinical outcome: Improved (complete recovery) and death. Severity and clinical outcome of OPC poisoning correlated with Serum Albumin and Serum Ferritin level on day 1 and day 3. Clinical outcome of OPC poisoning also correlated with POPS scale. Results: Out of 100 patients we studied, 74 (74%) patients had mild, 18 (18%) had moderate and 8 (8%) had severe poisoning according to POPS scale. Out of 100 patients, Outcome of patients was: 12 (12%) patients died and 88 (88%) survived. Correlation between POPS scale severity and clinical outcome was found to be statistically significant. Hypoalbuminemia and Increased Serum ferritin level on the day of admission and also the rate of change (on day 3) correlated with severity and outcome, which was found to be statistically significant. Conclusion: Hypoalbuminemia and increased serum ferritin level was linked with increasing severity and mortality risk in OPC poisoning. Specifically, serum albumin appears to have a protective effect that may influence the outcome in OP poisoning cases. Given this finding, there is a suggestion that the therapeutic potential of direct albumin replacement therapy should be explored for patients with low serum albumin levels in OP poisoning. They tell us about patient’s prognosis and guide the development of more effective treatment strategies.