DETERMINATION OF PROGNOSIS OF SNAKE BITE CASES BY NEUTROPHIL-LYMPHOCYTE RATIO AND PLATELET-LYMPHOCYTE RATIO.

Abstract

Objectives: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have recently gained popularity as simple, inexpensive, and highly accurate inflammatory markers and they have been suggested as useful predictors for clinical prognosis in critically ill patients in various medical conditions. Snakebites can result in serious complications. Our country is a snakebite-endemic area. The parameters for the prognosis of snakebites are very valuable due to the inadequacy of acute inpatient services, as well as the excessively intense traffic at emergency rooms (ERs); therefore, we aimed to detect the importance of the neutrophil–lymphocyte ratio (NLR) and the platelet–lymphocyte ratio (PLR) as parameters in the prognosis for snakebites. Methods: In this study, patients who presented at the ER within 24 hours after a snakebite were retrospectively analyzed. The sex, age, exposure duration, body part affected, hospitalization period, complications, mortality rate, and blood parameters of ER patients were assessed. Results: 51 healthy individuals who were suitable in terms of sex and age were included in the control group. It was detected that the average NLR (p=0.001) and PLR (p=0.005) values were statistically significantly higher in the patient group than in the control group. On comparing the patients discharged from the ER with those who remained hospitalized, the NLR (p= 0.002) and PLR (p= 0.006) values were significantly higher in the patients who remained hospitalized . The NLR (p=0.004) and the PLR (p=0.003) values in the patients who developed complications were significantly higher than those in patients who did not develop complications. Conclusion: High levels of on admission NLR and PLR were associated with worse clinical profile and poorer outcome. The hospitalization period, complication developments, and poor prognosis in snakebites may be predicted using the NLR and PLR values, which are easily available and inexpensive blood parameters.