Prognostic value of the neutrophil-to-lymphocyte ratio in acute organophosphorus pesticide poisoning.

Yuhang Mu,Li Pang,Nan Gao,Boqi Hu

doi:10.1515/biol-2021-0069

Abstract

This study investigates the ability of blood neutrophil-to-lymphocyte ratio (NLR) to predict acute organophosphorus pesticide poisoning (AOPP). Clinical data of 385 patients with AOPP were obtained within 24 h of admission, and NLR values were calculated based on neutrophil and lymphocyte counts. The patients were divided into two groups – good and poor – based on prognosis. Poor prognosis included in-hospital death and severe poisoning. The factors affecting prognosis were analyzed by logistic regression analysis, and the prognostic value of NLR was evaluated using the area under the receiver operating characteristic curve (AUC). Univariate logistic regression analysis showed that NLR levels, serum cholinesterase, and creatinine levels were good predictors of AOPP. Multivariate logistic regression analysis showed that high NLR was an independent risk factor for severe poisoning (adjusted odds ratio [AOR], 1.13; 95% CI, 1.10–1.17; p < 0.05) and in-hospital mortality (AOR, 1.07; 95% CI, 1.03–1.11; p < 0.05). NLR values >13 and >17 had a moderate ability to predict severe poisoning and in-hospital mortality, respectively (AUC of 0.782 [95% CI, 0.74–0.824] and 0.714 [95% CI, 0.626–0.803], respectively). Our results show that high NLR at admission is an independent indicator of poor prognosis in AOPP and can be used to optimize treatment and manage patients.

Highlights

Organophosphate pesticides (OPs) have been widely used for controlling agricultural and forestry pests worldwide since the 1930s because of their strong insecticidal effect and low cost
Data from 385 acute OP poisoning (AOPP) patients were included in the analysis
The rate of diabetes, number of neutrophils and lymphocytes, pChE, amylase, pH, lactate, number of patients with AOPP, and in-hospital mortality were significantly different across these three groups (Table 1)

Summary

Introduction

Organophosphate pesticides (OPs) have been widely used for controlling agricultural and forestry pests worldwide since the 1930s because of their strong insecticidal effect and low cost. Acute OP poisoning (AOPP) is a significant problem and a potential cause of mortality in the developing world, especially in Asian countries, because of the lack of regulation and easy availability of these products [1]. Disease severity is evaluated based on symptoms and routine laboratory tests. Typical symptoms include salivation, sweating, pupil constriction, and muscle fibrillation. Ill patients present respiratory failure, disturbance of consciousness, shock, and death. Initial symptoms are not detected in the emergency room in many patients because of prompt first aid

Methods

Results

Conclusion