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Influence of neutrophil/lymphocyte ratio on prognosis in mushroom poisoning

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Abstract

Objective: Mushroom poisoning is a severe poisoning which is commonly seen, particularly, in spring and autumn and may be fatal. This study aimed to study the influence of the neutrophil/lymphocyte ratio on prognosis in patients hospitalized in the toxicology unit with a diagnosis of mushroom poisoning. Methods: A total of 236 patients, admitted to the emergency room and hospitalized due to mushroom poisoning between July 2008 and March 2013, were retropsectively analysed. Patients were analysed in terms of age, gender, medical history, type of mushroom ingested, onset time of symptoms, complaints upon admission, and whether they received extracorporeal therapy and laboratory tests. Results: The mean age of patients hospitalized with mushrom poisoning was 41.88±17.81 years. Of the patients, 95 (40.3%) were male and 141 (59.7%) were female. In their medical history, 15 (64%) patients had diabetes mellitus, 8 (3.4%) had hypertension and 7 (3.0%) had coronary artery disease. 100 (42.4%) patients had eaten cultivated mushrooms, and 104 (44.1%) had eaten wild mushrooms. The mushroom type could not be determined in 32 (3.6%) patients. Symptoms appeared within the first 6 hours in 99 (84.3%) patients and after 6 hours in 37 (15.7%). Patients were usually admitted with nausea, vomiting, abdominal pain and diarrhea. 24 (10.2%) patients required hemoperfusion during their follow-up and treatment. Duration of hospital stay was 2.28±2.20 days in patients with normal liver functions, and 2 (0.8%) patients died. Neutrophil/lymphocyte ratio was 15.14±15.76 in patients with impaired liver functions, and this was statistically significant compared to patients with normal liver function tests (5.48±7.69) (p= 0.001). Conclusions: These results indicated that patients whose neutrophil/lymphocyte ratio is high upon admission should be monitored carefully both for prognosis and hemoperfusion requirement considering longer duration of hospital stay and more aggressive treatment options.

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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 Disease Markers 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]. ...
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