Prognostic Value of Red Cell Distribution Width in Patients with Organophosphate Poisoning

Dündar, Zerrin Defne; Köylü, Ramazan; Ergin, Mehmet; Günaydın, Yahya Kemal; Ozer, Rasit Serdar; Cander, Başar

doi:10.5152/jaem.2015.90692

Cited by 9 publications

(11 citation statements)

References 13 publications

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“…The ratio of patients who needed MV support was reported to be 34.2%(26/76 patients), 43.8% (49/112 patients), 20.8%(15/72 patients) and 24%(90/376 patients) in the studies of Muley et al, Lee et al, Dundar et al, and Eddleston et al respectively. 5 , 7 , 8 , 10 These studies reported that MV was a factor affecting hospitalization duration and long hospitalization durations were related to high mortality. 5 , 7 , 8 , 10 In our study, 22 of the 80 (27.5%) patients needed MV support, and hospitalization durations and mortality rates for these patients were higher than in those who did not need MV ( Table-II ).…”

Section: Discussionmentioning

confidence: 98%

Prognostic factors determining morbidity and mortality in organophosphate poisoning

Açıkalın¹,

Dişel²,

Matyar³

et al. 2017

Pak J Med Sci

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Objective:Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate (OP) poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature.Methods:In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department (ED) or intensive care unit (ICU) of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated. All the data were obtained from electronic and manual patient files. A total of 80 patients were included in the study.Results:The mean age of the study patients was 32.4±15.0 (13-94). Forty-nine (61.2%) patients were female. Twenty-two (27.5%) patients were seriously poisoned and needed mechanical ventilation (MV) support. Low pseudocholinesterase (PChE), high creatinine (Cr), low Glasgow Coma Scale (GCS) scores and long hospitalization durations were all found to be poor prognostics in MV patients. Low PChE and high Cr levels were found to be independent predictors of the hospitalization duration and high Cr was found to be an independent predictor of the intubation duration of MV patients in regression analyses. Ten (45.5%) of the MV patients were unresponsive to medical treatment and Therapeutic plasma exchange (TPE) was performed. Seven patients were discharged healthy. Three patients with low PChE levels and comorbidities died.Conclusions:Prolongation of respiratory depression necessitating MV support, comorbidities, long hospital stay, elevated creatinine, low GCS scores and low PcHE levels without regeneration in the first 48 hours of admission are all found to be poor prognostic factors for organophosphate (OP) poisoning.

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Section: Discussionmentioning

confidence: 98%

Prognostic factors determining morbidity and mortality in organophosphate poisoning

Açıkalın¹,

Dişel²,

Matyar³

et al. 2017

Pak J Med Sci

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“…A clinical trial found that RDW levels do not change in the patients with intoxication due to ingestion of low doses of organophosphates (37). Another study reported that RDW levels are an easy-to-use and valuable parameter in predicting the prognosis of patients poisoned with organophosphates (36). In our study, the mean RDW levels were significantly higher in the patient group who needed intensive care unit treatment compared to those who did not need this treatment.…”

Section: Discussionmentioning

confidence: 39%

“…However, it has been reported that a deformation of erythrocyte membranes due to acute or chronic inflammation may occur (35). Similarly, acute inflammation and oxidative stress, which are observed in organophosphate intoxication, may cause changes in the size and structure of circulating erythrocytes (36). A clinical trial found that RDW levels do not change in the patients with intoxication due to ingestion of low doses of organophosphates (37).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Clinical and Laboratory Prognostic Risk Factors in Organophosphate or Carbamate-Poisoned Pediatric Patients

Açıkgöz¹

2021

Eurasian J Emerg Med

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Aim:We aimed to determine the clinical and demographic features of pediatric patients monitored at our hospital after organophosphate or carbamate intoxication. Moreover, we aimed to determine the clinical and laboratory indicators that can affect the clinical severity scores and patients' prognosis. Materials and Methods:We retrospectively analyzed 117 patients, aged less than 18 years and admitted to the pediatric emergency department for organophosphate or carbamate intoxication. Results:The median age was 56 months (8-226 months), and the male-to-female ratio was 1.72 (74/43). The most frequent cause of intoxication was accidental ingestion (83.8%), and the oral route was the most common (73.5%). The Glasgow Coma Scale (GCS) score and serum pseudocholinesterase level were significantly low in the following groups: patients with a severe grade of intoxication, patients admitted to the intensive care unit, and patients with complications. However, lactate and glucose levels were significantly high in the previously mentioned patient groups (p<0.001). The mean range of red cell distribution width was significantly higher in patients admitted to the intensive care unit compared with those monitored in the emergency department (p=0.029). Conclusion:This study shows that GCS score and serum pseudocholinesterase, glucose, and lactate levels at baseline can be helpful in predicting the presence of a serious intoxication and aid in the prognosis of pediatric patients.

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“…Several studies revealed the value of hematological parameters in predicting short- or long-term mortality in patients with acute myocardial infarction [ 15 ], sepsis and septic shock [ 16 ], acute pancreatitis [ 17 ], or in critically ill patients [ 18 ]. Also, there were studies which analyzed either hs-CRP or hematological parameters in relation with short-term outcomes in poisoning: leukocyte, neutrophil counts, and NLR in paraquat poisoning [ 19 ], NLR in mushroom [ 20 ] and CO poisoning [ 21 ], hs-CRP [ 22 ], and RDW in organophosphate poisoning [ 5 ]. In CO poisoning, it was revealed that there is a correlation between RDW and long-term outcomes [ 3 ] and between SII and neurological outcomes [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Biomarkers of Inflammation and Inflammation-Related Indexes upon Emergency Department Admission Are Predictive for the Risk of Intensive Care Unit Hospitalization and Mortality in Acute Poisoning: A 6-Year Prospective Observational Study

et al. 2021

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Patients poisoned with drugs and nonpharmaceutical substances are frequently admitted from the emergency department (ED) to a medical or ICU department. We hypothesized that biomarkers of inflammation and inflammation-related indexes based on the complete blood cell (CBC) count can identify acutely poisoned patients at increased risk for ICU hospitalization and death. We performed a 6-year prospective cohort study on 1548 adult patients. The demographic data, the levels of hs-CRP (high-sensitivity C-reactive protein), CBC, and inflammation-related indexes based on CBC counts were collected upon admission and compared between survivors and nonsurvivors, based on the poison involved. Both a multivariate logistic regression model with only significant univariate predictors and a model including univariate predictors plus each log-transformed inflammation-related indexes for mortality were constructed. The importance of the variables for mortality was graphically represented using the nomogram. hs-CRP (odds ratio (OR), 1.38; 95% CI, 1.16–1.65, p < 0.001 for log-transformed hs-CRP), red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were significantly associated with the risk of ICU hospitalization, after multivariable adjustment. Only RDW, NLR, and monocyte-lymphocyte ratio (MLR) were significantly associated with mortality. The predictive accuracy for mortality of the models which included either NLR (AUC 0.917, 95% CI 0.886-0.948) or MLR (AUC 0.916, 95% CI 0.884-0.948) showed a high ability for prognostic detection. The use of hs-CRP, RDW, NLR, and MLR upon ED admission are promising screening tools for predicting the outcomes of patients acutely intoxicated with undifferentiated poisons.

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Prognostic Value of Red Cell Distribution Width in Patients with Organophosphate Poisoning

Cited by 9 publications

References 13 publications

Prognostic factors determining morbidity and mortality in organophosphate poisoning

Prognostic factors determining morbidity and mortality in organophosphate poisoning

Evaluation of Clinical and Laboratory Prognostic Risk Factors in Organophosphate or Carbamate-Poisoned Pediatric Patients

Biomarkers of Inflammation and Inflammation-Related Indexes upon Emergency Department Admission Are Predictive for the Risk of Intensive Care Unit Hospitalization and Mortality in Acute Poisoning: A 6-Year Prospective Observational Study

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