Prediction Of Prognosis And Respiratory Failure In Patients With Acute Organophosphorus Poisoning By Neutrophil To Lymphocyte Ratio

Objective:By analyzing the clinical data of patients with acute organophosphorus pesticide poisoning(AOPP),the risk factors affecting the prognosis and respiratory failure of the patients were studied to provide a basis for the assessment of the condition of patients with AOPP.Methods:A retrospective analysis of the clinical data of 381 patients with AOPP hospitalized in the First Hospital of Jilin University from January 2014 to January 2019,including age,white blood cells(WBC),and neutrophil count(NC),lymphocyte count(LC),neutrophil/lymphocyte ratio(NLR),cholinesterase(ChE),amylase,blood urea nitrogen(BUN),creatinine(Cr),alanine aminotransferase(ALT),aspartate amino transferase(AST),creatine kinase isoenzyme(CKMB),albumin.The patients were divided into survival group and death group according to their condition at discharge.According to the results of arterial blood gas examination,patients were divided into respiratory failure group and non-respiratory failure group.Comparing clinical data to analyze independent risk factors and changes in mortality,incidence of respiratory failure,and NLR as the degree of poisoning increases.Results:(1)Differences in age,albumin,WBC,NC,NLR,ChE,amylase,BUN,Cr,AST,ALT were statistically significant between the survival and death groups(P<0.05);Binary logistic regression analysis showed that age,NC,NLR,and albumin had statistically significant difference between survival group and death group(P<0.05);ROC curve analysis showed that the area under the death curve(AUC)predicted by NLR for AOPP patients was 0.861 [95% confidence interval =(0.822,0.894)],and its sensitivity and specificity were 81.6% and 81.3%,respectively.(2)Age,albumin,WBC,NC,NLR,ChE,amylase,BUN,Cr,AST,ALT were statistically significant in the respiratory failure group and non-respiratory failure group(P<0.05);binary logistic regression analysis showed Age,NC,NLR,and albumin were statistically significant between the two groups(P<0.05).(3)As the degree of poisoning increased,the NLR was 6.73,8.11,and 12.79,the mortality was 1.4%,2.7%,and 17.5%,and the incidence of respiratory failure was 2.1%,5.4%,and 27.5%,respectively.There were significant differences in NLR,mortality,and incidence of respiratory failure between groups(P< 0.05)Conclusion:(1)Age,NC,NLR are independent risk factors affecting the prognosis and respiratory failure of AOPP patients;albumin is an independent protective factor affecting the prognosis and respiratory failure of AOPP patients,Albumin supplement therapy may be given to older and severe conditions patients if necessary.(2)As the degree of poisoning increases,the NLR,mortality,and respiratory failure rates of AOPP patients gradually increase.There are statistically significant differences between groups with different poisoning levels(3)In the process of clinical diagnosis and treatment,in the face of NLR can be used to guide clinical medication and judge prognosis patients whose condition severity inconsistent the decline of cholinesterase.