Neutrophil-to-lymphocyte ratio versus platelet-to-lymphocyte ratio in predicting clinical outcomes in acute methanol poisoning

Abstract

Acute methanol poisoning is a global health concern. This study was designed to compare the prognostic roles of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and their combination in the prediction of clinical outcomes in methanol-intoxicated patients as well as to evaluate their associations with all initial patients’ characteristics. We conducted a cross-sectional study among methanol-intoxicated patients. A total of 109 patients were enrolled in the study. Thirty-four (31%) patients died during hospital admission while 30 (27.5%) patients developed visual loss. Most of the unfavorable findings were evident in patients with high NLR and PLR. Neutrophil-to-lymphocyte ratio and PLR can excellently differentiate between survivors and non-survivors with an area under the curve (AUC) of 0.991 vs 0.923, respectively. Platelet-to-lymphocyte ratio showed an accepted discrimination ability to differentiate between patients who developed and patients who did not develop visual loss, AUC of 0.734, however, NLR showed no discrimination, AUC of 0.558. We concluded that NLR and PLR can serve as valuable tools in risk-stratifying patients and prognosticating outcomes in acute methanol poisoning. Platelet-to-lymphocyte ratio is superior to NLR as a predictive factor in patients with permanent visual impairment. However, a combination of NLR with PLR can develop a more powerful prediction for overall clinical outcomes.

An Outbreak of Home Distillation Methanol Poisoning in Turkey During the COVID-19 Pandemic: A Single Center Experience

“…However, in a study evaluating 109 methanol poisoning patients, the researchers noted that NLR was able to distinguish death and survival with high performance, but it was ineffective in predicting vision loss. 25 The researchers reported that the use of the platelet-to-lymphocyte ratio will provide better results than NLR in predicting permanent vision loss. 25 There are also studies reporting that the red blood cell distribution width value, which is one of the hemogram parameters, is statistically significantly higher in patients who died from methanol poisoning compared to those who survived.…”

“… 25 The researchers reported that the use of the platelet-to-lymphocyte ratio will provide better results than NLR in predicting permanent vision loss. 25 There are also studies reporting that the red blood cell distribution width value, which is one of the hemogram parameters, is statistically significantly higher in patients who died from methanol poisoning compared to those who survived. 23 …”

Fatal Methanol Poisoning Caused by Drinking Industrial Alcohol: Silesia Region, Poland, April–June 2022

“…Future research should focus on possible predictors of the risk of death from methanol poisoning. Abdelwahab et al, proposed to use the neutrophil-to-lymphocyte ratio and the platelet-tolymphocyte ratio as predictors for acute methanol poisoning [30]. Future research must focus on the early symptoms of methanol poisoning and carefully examine the changes in the body that occur immediately after ingestion.…”