Study The Role of Glasgow coma Scale, Neutrophil-Lymphocyte ratio, Platelet-Lymphocyte ratio, and Serum Creatinine as predictors of severity and mortality in acute organophosphorus poisoning

Background: Organophosphorus compounds (OPCs) are extremely toxic to humans. Aim: To evaluate the role of the Glasgow Coma Scale, Neutrophil-Lymphocyte ratio (NLR), Platelet-Lymphocyte ratio (PLR), and serum creatinine as predictors of severity and mortality among acutely poisoned OPC patients. Methodology: A cross-sectional prospective study was performed on 50 acutely OPC-poisoned patients admitted to the poison control center Ain Shams University Hospitals (PCC-ASUHs), from start of June 2022 to the end of June 2023. The diagnosis confirmed by a low pseudocholinesterase level. Personal, toxicological history, clinical examination and classification of the patients according to the severity of poisoning by the Peradeniya Organophosphorus Poisoning (POP) score. GCS was calculated on admission. NLR, PLR, and serum creatinine were estimated on admission and repeated after 24 hours. Results: 54% of patients were moderate, 24% were severe, and 22% were mild. Among the studied patients, 16% died and 84% were discharged. There was a statistically significant relationship between GCS and the severity, mortality. A 24-hour NLR was significantly associated with the indication of mechanical ventilation. PLR on admission and after 24 hours were significantly related to the severity. Serum creatinine on admission and after 24 hours was statistically significantly related to mortality. Conclusion: GCS is a better predictor of the severity and mortality after OPCs poisoning. There is a significant correlation between 24 hour NLR and PLR and the need for mechanical ventilation. Serum creatinine after 24 hours of more than 1mg/dL can be used as a predictor of mortality in acute OPCs poisoning.