title: Neutrophil-lymphocyte ratio in patients with pesticide poisoning.
abstract: BACKGROUND
  Pesticides are highly toxic to human beings, and pesticide poisoning is associated with high morbidity and mortality. The identification of powerful prognostic markers is important for the management of patients with pesticide poisoning in emergency settings.
  
  
  OBJECTIVE
  To investigate the prognostic value of the neutrophil-lymphocyte ratio and hematological parameters measured in patients with pesticide poisoning within the first 24 h after admission to the emergency department (ED).
  
  
  METHODS
  All patients (≥15 years old) admitted to the ED from July 2008 through February 2013 due to pesticide poisoning were enrolled in the study. The written and electronic medical charts of patients were reviewed. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio were calculated for each patient using absolute neutrophil, lymphocyte, and platelet counts. Mechanical ventilation requirement and mortality were used as the primary endpoints.
  
  
  RESULTS
  A total of 189 patients were included in the study. The mechanically ventilated patients had significantly higher leukocyte and neutrophil counts, and neutrophil-lymphocyte and platelet-lymphocyte ratios (p < 0.001, p < 0.001, p < 0.001, p = 0.003, respectively), whereas they had significantly lower lymphocyte counts compared to nonventilated patients (p = 0.011). Survivors had significantly higher leukocyte and neutrophil counts, and neutrophil-lymphocyte ratios (p < 0.001, p < 0.001, p = 0.002, respectively), whereas there was no significant difference between groups in terms of lymphocyte counts (p = 0.463), compared to nonsurvivors.
  
  
  CONCLUSIONS
  Leukocyte counts, neutrophil counts, and neutrophil-lymphocyte ratios measured within the first 24 h after admission to the ED are useful and easy-to-use parameters for estimating prognosis in the follow-up of patients with pesticide poisoning.
authors: Emergency Medicine Department, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors: Zerrin Defne
authors: ZD
authors: Dundar
authors: Emergency Medicine Department, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors: Mehmet
authors: M
authors: Ergin
authors: Emergency Medicine Clinic, Konya Training and Research Hospital, Konya, Turkey.
authors: Ramazan
authors: R
authors: Koylu
authors: Emergency Medicine Department, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors: Rasit
authors: R
authors: Ozer
authors: Emergency Medicine Department, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors: Basar
authors: B
authors: Cander
authors: Emergency Medicine Clinic, Konya Training and Research Hospital, Konya, Turkey.
authors: Yahya Kemal
authors: YK
authors: Gunaydin
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D010575:Pesticides / Q000506:poisoning*; D011041:Poisoning / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D010575:Pesticides
keywords: cholinesterase; neutrophil-lymphocyte ratio; pesticide; poisoning