Serum amylase as a novel prognostic marker of organophosphorus poisoning: a retrospective study

Abstract

Background: This study aims to explore the significance of serum amylase levels in patients with organophosphorus pesticide (OP) poisoning and to provide a new perspective for evaluating the severity and prognosis of OP poisoning.

Methods: The clinical data of 67 patients with acute OP poisoning, who had been treated in the emergency department of the General Hospital of Ningxia Medical University between September 2020 and August 2022, were retrospectively analyzed. Using Spearman rank correlation, serum amylase levels during admission and severity of poisoning correlated with discharge outcomes. Based on serum amylase levels, receiver operating characteristic curves were plotted to predict the severity and mortality of patients who experience organophosphate poisoning. The optimal threshold serum amylase level at admission was determined based on the maximum Youden index.

Results: Using Spearman rank correlation analysis, serum amylase levels at admission positively correlated with the severity of poisoning and discharge outcomes, but the degree of correlation was weak (r_s: 0.344; 0.264; P < 0.05). The patients’ serum amylase levels at admission had receiver operating characteristic area under the curve values of 0.726 and 0.735 to predict the degree of severe poisoning and death, respectively. Based on the maximum Youden index, the optimal threshold of serum amylase were 97.8 and 194.1 U/L when the degree of poisoning was severe and the discharge outcome of patients was died. In comparison to patients with serum amylase levels ≤194.1 U/L at admission, the OR values of death in patients with serum amylase levels >194.1 U/L at admission was 15.944 (95% CI: 1.825-139.274).

Conclusion: Serum amylase levels in patients with organophosphate poisoning correlate with the degree of poisoning and discharge outcomes. Higher serum amylase level was a risk factor for organophosphorus poisoning death.

Keywords

Amylase / Emergency department / Organophosphorus pesticide poisoning / Prognosis

Conflict of interest statement

The authors declare no conflict of interest.

Author contributions

Guo X performed the statistical analysis and wrote the manuscript; Chen Z provided poisoning-related professional knowledge and proofread the manuscript; Feng K acquired financial support for the project leading to this publication; Zeng S and Zhang J conducted the data collection; Ma Z and Yuan C provided statistical advice. All authors read and approved the final manuscript.

Funding

None.

Ethical approval of studies and informed consent

The study followed the principles of the Declaration of Helsinki as revised in 2013. This study was approved by Ningxia Medical University General Hospital’s Ethics Committee (Ethics Number: KYLL-2022-1243). Written informed consent was waived owing to the anonymous nature of the data.

Acknowledgments

None.

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