Prognostic values of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in the early prediction of aluminum phosphide-poisoned patients' outcomes

• Published in: Immunopharmacology and immunotoxicology Vol. 46; no. 6; p. 843
• Main Authors: Rezk, Meriam N N, Fekry Hanna, Chrestina Monir, Shafek Keryakous, Mariem Maher, Welson, Nermeen N
• Format: Journal Article
• Language: English
• Published: England 01.12.2024
• Subjects: Adult; Aluminum Compounds - poisoning; Blood Platelets - pathology; Egypt; Female; Humans; Lymphocytes; Male; Middle Aged; Neutrophils; Phosphines - poisoning; Predictive Value of Tests; Prognosis; Respiration, Artificial; Young Adult; Egypt; Aluminum phosphide (ALP) poisoning; neutrophil-to-lymphocyte ratio (NLR); mechanical ventilation; prognosis; platelets-to-lymphocyte ratio (PLR)
• ISSN: 1532-2513
• DOI: 10.1080/08923973.2024.2415114

In Egypt, aluminum phosphide (ALP) is one of the most serious health problems that threaten the health system, with a very high mortality rate that ranges from 30%-100% of cases, according to medical facilities. ALP records suicidal deaths related to the toxin ingestion in Egypt, which accounts for 70% of the deaths. Patients usually deteriorate early; death is expected in the first 48 h. The aim of this study is to investigate the early recorded neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in anticipation of the ALP-intoxicated patients' outcome. Thirty-three subjects diagnosed with ALP poisoning were divided into two groups according to their need for mechanical ventilation and whether they could survive or not. A complete blood count (CBC) was done immediately after admission, and NLR and PLR were calculated. Patients' conditions were evaluated by arterial blood gases (ABG), random blood sugar (RBS), sodium (Na ), potassium (K ), and an electrocardiogram (ECG). There were significant differences in the need for ICU and mechanical ventilation between the different NLR groups. There was also a highly significant difference in the patient's fate. Increased NLR was associated with a high incidence of mechanical ventilation and death in ALP-poisoned patients. The early assessment of NLR can be valuable in predicting death and the need for ICU admission. NLR 3.35 can predict death in ALP-poisoned patients. Early CBC and calculation of NLR are promising tools that are easy and more accurate than the presence of leukocytosis or leucopenia.