Predictive Value Of PSS,NLR Combined With CHE For Early Mechanical Ventilation In Patients With Acute Organophosphorus Poisoning

Objective(s): To analyze the correlation between poisoning severity score(PSS),neutrophil/lymphocyte ratio(NLR),cholinesterase(CHE)and early mechanical ventilation in patients with acute organophosphate poisoning(AOPP),and explore the Its predictive value for early mechanical ventilation in patients with AOPP poisoning.Methods: The clinical data of AOPP patients admitted to the Emergency Medicine Department of the Second Affiliated Hospital of Kunming Medical University from January 2015 to September 2022 were retrospectively analyzed,including age,gender,PSS,NLR,CHE,body temperature,heart rate,systolic blood pressure,diastolic blood pressure,and respiratory rate.Frequency,time from poisoning to treatment,etc.According to whether patients received mechanical ventilation within 24 hours of admission,they were divided into mechanical ventilation group and non-mechanical ventilation group.The general clinical characteristics,first admission PSS,NLR and CHE were compared between the two groups.Binary Logistic regression analysis was performed on the indicators with differences to obtain the relevant risk factors.The receiver operating characteristic curve(ROC)was drawn to detect the best cut-off values of PSS,NLR,and CHE,and the differences in the area under the ROC curve(AUC)of PSS,NLR,CHE,and the combination of the three were compared.Results: 1.A total of 110 patients were included in this study,including 54 cases in the mechanical ventilation group,with an average age of 52.94±16.14 years,and 56 cases in the non-mechanical ventilation group,with an average age of 40.80±15.34 years.There was no significant difference between the two groups in age,gender,past history(including coronary heart disease,hypertension,diabetes and other diseases),heart rate,body temperature,respiratory rate,systolic blood pressure,diastolic blood pressure,time from poisoning to treatment(p> 0.05).2.The PSS score and NLR in the non-mechanical ventilation group were significantly lower than those in the mechanical ventilation group,and the CHE activity was significantly higher than that in the mechanical ventilation group,and the differences were statistically significant(p<0.05).3.PSS,NLR,and CHE are all related risk factors for early mechanical ventilation in AOPP patients(p<0.05),and the best cut-off values are 2.5 points(sensitivity 53.7%,specificity 96.4%),10.138(sensitivity 64.8%),respectively.%,specificity 91.1%)and239.5U/L(sensitivity 57.4%,specificity 89.3%).4.The AUCs of PSS,NLR,CHE and their combination were 0.794(95%CI: 0.710-0.879),0.818(95%CI: 0.739-0.898),0.786(95%CI: 0.703-0.870),0.909(95%CI: 0.855-0.964),the combined AUC of the three was the largest,and the difference was statistically significant(p<0.05).Conclusion(s): 1.PSS,NLR,and CHE are related risk factors for early mechanical ventilation in AOPP patients,and their optimal cut-off values are 2.5 points,10.138,and 239.5 U/L,respectively.2.The AUC of PSS,NLR combined with CHE is the largest,and has the highest value in predicting early mechanical ventilation in AOPP patients.