The Effects of Magnesium Levels on Prognosis in Organophosphate Poisoning

Year 2019, Volume: 1 Issue: 1, 7 - 10, 01.03.2019

İsmail Aktaş , Ramazan Köylü Öznur Köylü Başar Cander

Abstract

Objectives: To investigate the predictive value of magnesium, neutrophil/lymphocyte ratios (NLR) in determining the severity of morbidity and mortality

in patients with organophosphate poisoning (OP) admitted to the emergency department.

Materials ad Methods: This study was conducted retrospectively by scanning the medical recordings of patients aged over 18 years who were admitted

to our emergency department with OP between 2010 and 2015. The demographic characteristics, medical history, laboratory findings, and Glasgow Coma

Scale (GCS) scores of the patients were recorded.

Results: The data of 153 patients, 91 males and 62 females, were evaluated. There was no significant correlation between the changes in magnesium,

hemoglobin, hematocrit, leukocytosis, platelets, potassium, calcium, glucose, alanine aminotransferase (ALT), troponin, and mortality in patients with OP

(p>0.05). There was a significant relationship between the increase in lactate dehydrogenase (LDH) (p=0.004), low lymphocyte count (p=0.003), decreased

cholinesterase (p=0.001), higher (NLR) (p=0.002), GCS (p<0.001), mechanical ventilator (MV) requirement (p<0.001), age (P=0.009), vasopressor treatment

(p<0.001), and mortality.

Conclusion: No significant relationship determined between magnesium levels and prognosis. Low lymphocyte count, decreased cholinesterase, increased

LDH and NLR in patients with OP were significantly correlated with mortality. Increased NLR ratio, one of the parameters in routine hemograms, may give

information to physicians about the long-term follow-up of such patients with OP.

Keywords

Emergency, Organophosphate, Magnesium, Neutrophil lymphocyte ratio

References

• REFERENCES1. Sogorb MA, Vilanova E, Carrera V. Future applications of phosphotriesterases in the prophylaxis and treatment of organophosporus insecticide and nerve agent poisonings. Toxicology letters. 2004;151(1):219-33.2. Langley R, Sumner D. Pesticide mortality in the United States 1979-1998. Veterinary and human toxicology. 2002;44(2):101-5.3. Öztürk MA, Kelestimur F, Kurtoglu S, Güven K, Arslan D. Anticholinesterase poisoning in Turkey-clinical, laboratory and adiologic evaluation of 269 cases. Human & experimental toxicology. 1990;9(5):273-9.4. Karalliedde L. Organophosphorus poisoning and anaesthesia. Anaesthesia. 1999;54(11):1073-88.5. Jeyaratnam J. Acute pesticide poisoning: a major global health problem. World Health Stat Q. 1990;43(3):139-44.6. Güven M, Sungur M. Organophosphorus poisonings and future directions. Current Topics in Toxicology, Volume 2. 2005:57-65.7. Kwong TC. Organophosphate pesticides: biochemistry and clinical toxicology. Therapeutic drug monitoring. 2002;24(1):144-9.8. Lowsby R, Gomes C, Jarman I, Lisboa P, Nee PA, Vardhan M, Eckersley T, Saleh R, Mills H. (2015). Neutrophil to lymphocyte count ratio as an early indicator of blood stream infection in the emergency department. Emerg Med J. 32(7):531-4.9. Duffy BK, Gurm HS, Rajagopal V. (2006). Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 97:993-6, 996.10. Tamhane UU, Aneja S, Montgomery D. (2010). Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 102:653-7.11. Tsujimura A, Kawamura N, Ichimura T, et al. (2002). Telomerase activity in needle biopsied uterine myoma-like tumors: differential diagnosis between uterine sarcomas and leiomyomas. Int J Oncol; 20:361-365.12. Clark RF. Insecticides: organic phosphorus compounds and carbamates. Goldfrank's toxicologic emergencies. 2002;8:1497-512.13. Peter JV, Moran JL, Graham P. Oxime therapy and outcomes in human organophosphate poisoning: an evaluation using meta-analytic techniques. Critical care medicine. 2006;34(2):502-10.14. Goodman DA, Goodman CB, Monk JS. Use of the neutrophil:lymphocyte ratio in the diagnosis of appendicitis. Am Surg 1995; 61:257-259.15. Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S. (2012). T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol 23: 265-7316. Jilma B, Blann A, Pernerstorfer T. (1999). Regulation of adhesion molecules during human endotoxemia. No acute effects of aspirin. Am J Respir Crit Care Med 159:857-63.17. Buck BH, Liebeskind DS, Saver JL, Bang OY, Yun SW, Starkman S, et al. Early neutrophilia is associated with volume of ischemic tissue in acute stroke. Stroke. 2008;39(2):355-60.18. Sönmez O, Ertaş G, Bacaksız A, Tasal A, Erdoğan E, Asoğlu E. (2013). Relation of neutrophil-to-lymphocyte ratio with the presence and complexity of coronary artery disease: an observational study. Anadolu Kardiyol Derg. 13:662-7.19. Kılıçaslan B, Dursun H, Kaymak S, Aydın M, Ekmekçi C, Susam İ. (2015). The relationship between neutrophil to lymphocyte ratio and blood pressure variability in hypertensive and normotensive subjecs. Turk Kardiyol Dern Ars. 43(1):18-2420. Elbey B, Yazgan ÜC, Yıldırım A, Karaalp Ü, Şahin A. (2015). Vernal keratokonjonktivitli olgularda ortalama trombosit hacmi ve nötrofil/lenfosit oranı. Journal of Clinical and Experimental Investigations. 6(1):40-3.