White Blood Cell to Platelet Ratio as a Marker of Adverse Outcome in Organophosphate Poisoning: A Retrospective Cross-Sectional Survey

Abstract

Introduction: Organophosphorus compounds are pesticides commonly used for agricultural purposes. However, by nature they are poisonous, and administration either accidental or intentional is a medical emergency requiring prompt evaluation and treatment, and can even lead to death. In addition due to the ease of their availability, they are commonly used for self-harm/suicidal purposes. Many of the patients are initially managed at primary or secondary healthcare setups before being referred to tertiary care hospitals. The purpose of our study is to find a prognostic marker in the initial blood work of these patients.

Materials and Methods: A total of 46 patients were included in this retrospective cross-sectional survey conducted at the Department of Emergency Medicine, Holy Family Hospital, Rawalpindi. Data were collected from patient files using specific questionnaires. Outcomes were defined in terms of Emergency Department disposition. Data were analysed using SPSS v25. A univariate analysis, followed by Spearman’s Correlation was used.

Results: Patients with a higher WBC to Platelet ratio had worse outcomes. The Spearman’s rho correlation coefficient was calculated and a moderately strong correlation (rho = .458, p < .001) was found. Conclusion: WBC to Platelet ratio is a hematological parameter determined to be most strongly correlated with adverse outcomes in Organophosphate Poisoning. It has a statistically significant stronger correlation than the WBC count alone. However, further extensive and focused studies are needed to corroborate these findings and substantiate them as a definite marker of prognostic significance.

Keywords: Organophosphate Poisoning; Emergency Medicine; ED; White Blood Cells; Emergency Care; Patient Outcome Assessment.