TY  - JOUR
T1  - Systemic Inflammatory Markers (NLR/PLR) and Climatic Factors as Predictors of Severity in Pediatric Carbon Monoxide Poisoning
AU  - Memiş, Sebahattin
AU  - Demirtaş, Mehmet Semih
AU  - Erdal, Hüseyin
AU  - Sorkulu Memiş, Gizem
AU  - Tuşat, Mustafa
AU  - Özdemir Kaçer, Emine
PY  - 2025
DA  - September
Y2  - 2025
DO  - 10.37990/medr.1726333
JF  - Medical Records
JO  - Med Records
PB  - Tıbbi Kayıtlar Derneği
WT  - DergiPark
SN  - 2687-4555
SP  - 756
EP  - 62
VL  - 7
IS  - 3
LA  - en
AB  - Aim: Carbon monoxide (CO) poisoning remains a global health challenge, particularly in developing nations. This study evaluates the prognostic role of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and climatic parameters in pediatric CO poisoning severity.Material and Method: In this retrospective cohort study, 132 pediatric patients admitted to a tertiary emergency department were stratified by carboxyhemoglobin (COHb) levels (mild: <5%; moderate: 5–25%; severe: >25%). Associations between NLR/PLR, meteorological data (temperature, wind speed, air pressure), and clinical outcomes were analyzed.Results: Severe cases exhibited significantly elevated NLR (2.09 [IQR 1.24-3.54]; p=0.019) and PLR (106.2 [80.6-164.4]; p=0.032) compared to others, alongside higher COHb (31.45 [27.25-34.2]; p<0.001) and lactate (2.7 [1.8-3.45] mmol/L; p=0.07). Central nervous system symptoms (CNS) predominated in severe poisoning (28.6%, p=0.014). Maximum temperature was inversely correlated with severity (p=0.032).Conclusion: NLR and PLR serve as early indicators of CO poisoning severity, while higher air temperatures reduce risk. These findings support using routine hemogram indices for risk stratification and underscore the need for climate-aware public health interventions.
KW  - Carbon monoxide poisoning
KW  - air temperature
KW  - children
KW  - systemic immune/inflammatory index markers
KW  - temperature
CR  - Rose JJ, Wang L, Xu Q, et al. Carbon monoxide poisoning: pathogenesis, management, and future directions of therapy. Am J Respir Crit Care Med. 2017;195:596-606. Erratum in: Am J Respir Crit Care Med. 2017;196:398-9.
CR  - Yonetani T, Park SI, Tsuneshige A, et al. Global allostery model of hemoglobin. Modulation of O(2) affinity, cooperativity, and Bohr effect by heterotropic allosteric effectors. J Biol Chem. 2002;277:34508-20.
CR  - The Lancet Public H. Carbon monoxide poisoning: largely preventable. Lancet Public Health. 2023;8:e827.
CR  - Hampson NB, Hauff NM. Risk factors for short-term mortality from carbon monoxide poisoning treated with hyperbaric oxygen. Crit Care Med. 2008;36:2523-7.
CR  - Teksam O, Gumus P, Bayrakci B, et al. Acute cardiac effects of carbon monoxide poisoning in children. Eur J Emerg Med. 2010;17:192-6.
CR  - Demirtas MS, Memiş S, Kocagözoğlu SG. Evaluation of hemoglobin, albumin, lymphocyte, and platelet score, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio in pediatric patients with rotavirus enteritis. J Clin Pract Res. 2025;47:28-35.
CR  - Bagci Z, Arslan A, Arslan D. The value of neutrophil: lymphocyte ratio and platelet: lymphocyte ratio in predicting clinical severity in children with carbon monoxide poisoning. Indian J Pediatr. 2021;88:1121-6.
CR  - Ruan HL, Deng WS, Wang Y, et al. Carbon monoxide poisoning: a prediction model using meteorological factors and air pollutant. BMC Proc. 2021;15:1.
CR  - Chen F, Ye Y, Wei Q, et al. Non-fire related carbon monoxide poisoning in Sichuan, China: a 9-year study (2008-2016). Iran J Public Health. 2019;48:458-64.
CR  - Kurt F, Bektaş Ö, Kalkan G, et al. Does age affect presenting symptoms in children with carbon monoxide poisoning?. Pediatr Emerg Care. 2013;29:916-21.
CR  - Yalçın G, Yalçın KE, Atasoy Hİ. Predictive value of complete blood count, venous blood gas measurements, and glucose/potassium ratio for delayed neuropsychiatric syndrome in children with acute carbon monoxide poisoning due to coal-burning stove. Turk Arch Pediatr. 2023;58:328-35.
CR  - Alharthy N, Alanazi A, Almoqaytib A, et al. Demographics and clinical characteristics of carbon monoxide poisoning for patients attending in the emergency department at a tertiary hospital in Riyadh, Saudi Arabia. Int J Emerg Med. 2024;17:25.
CR  - Al-Moamary MS, Al-Shammary AS, Al-Shimemeri AA, et al. Complications of carbon monoxide poisoning. Saudi Med J. 2000;21:361-3.
CR  - Zhang Y, Lu Q, Jia J, et al. Multicenter retrospective analysis of the risk factors for delayed neurological sequelae after acute carbon monoxide poisoning. Am J Emerg Med. 2021;46:165-9.
CR  - Keleş A, Demircan A, Kurtoğlu G. Carbon monoxide poisoning: How many patients do we miss?. Eur J Emerg Med. 2008;15:154-7.
CR  - Roca-Barcelo A, Crabbe H, Ghosh R, et al. Temporal trends and demographic risk factors for hospital admissions due to carbon monoxide poisoning in England. Prev Med. 2020;136:106104.
CR  - Wang CH, Shao SC, Chang KC, et al. Quantifying the effects of climate factors on carbon monoxide poisoning: a retrospective study in Taiwan. Front Public Health. 2021;9:718846.
UR  - https://doi.org/10.37990/medr.1726333
L1  - https://dergipark.org.tr/tr/download/article-file/4987314
ER  -