A study of white blood cell counts as a prognostic marker among patients sustaining organophosphate poisoning presenting to the Emergency Department of a Tertiary Care Hospital

Abstract

Abstract Background: Organophosphate (OP) pesticide poisoning is a primary concern in rural regions of developing nations, posing a significant clinical challenge. The mortality rate from acute OP compound poisoning surpasses any other harmful substance. In the case of stressful events like injuries and poisoning, the observed leucocytosis and neutrophilia can be attributed to neutrophil margination rather than an increase in bone marrow production. Materials and Methods: Between June 2020 and September 2021, a prospective observational study was conducted at a tertiary care institute in Tamil Nadu. The study included 50 patients admitted to the Institute’s Medical Emergency Ward with suspected Organophosphorus poisoning. These patients were categorized into three grades, mild, moderate, and severe, using Dresbach’s classification based on the severity of their manifestations. Results: Among the 50 cases studied, 29 were females, and 21 were males. The predominant agent is responsible for organophosphate (OP) poisoning was chlorpyrifos, affecting 37 patients. Most cases (78%) presented with mild manifestations, 12% presented with moderate presentations, and 10% had severe manifestations. Most (72%) of patients sought medical attention within 4 h of consumption (n = 36). Conclusion: While insufficient to confirm or rule out severe poisoning, leukocyte counts hold some moderate capacity to differentiate between patients with and without significant poisoning. As a result, these counts could have a meaningful impact on decisions regarding patient disposition.