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Is there any relationship between initial hematological parameters and severity of scorpion envenomation?
Özden Özgür Horoz1, Dinçer Yıldızdaş1, Nagehan Aslan1
1Divisions of Pediatric Intensive Care Unit, Çukurova University Faculty of Medicine, Adana, Turkey.
Insights
The neutrophil-to-lymphocyte ratio (NLR) can help predict severe scorpion envenomation in children. Higher NLR values indicate a greater need for intensive care, aiding in early risk assessment.
Area of Science:
- Pediatric Emergency Medicine
- Toxicology
- Hematology
Background:
- Severe scorpion envenomation disproportionately affects children, leading to significant morbidity and mortality.
- Systemic inflammatory response and multi-organ involvement are critical challenges in severe envenomation.
- Understanding early indicators is crucial for managing pediatric scorpion stings.
Purpose of the Study:
- To investigate the relationship between initial hematological parameters and the severity of scorpion envenomation in pediatric patients.
- To identify potential biomarkers for predicting severe outcomes in children stung by scorpions.
- To evaluate the utility of hematological indices in assessing envenomation severity.
Main Methods:
- Retrospective study conducted in pediatric emergency and intensive care units.
- Inclusion of 257 pediatric scorpion envenomation cases and 115 healthy controls.
- Analysis of hematological parameters including white blood cell, neutrophil, lymphocyte, platelet counts, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and PDW.
Main Results:
- Pediatric scorpion envenomation patients exhibited higher white blood cell, neutrophil, lymphocyte, platelet, NLR, PLR, and PDW values compared to controls.
- A decision tree model indicated that patients with NLR values below 2.1, presenting within one hour, had an 87.5% chance of not requiring intensive care.
- Conversely, patients with NLR values above 1.969 were more likely (54.1%) to require intensive care unit hospitalization.
Conclusions:
- The neutrophil-to-lymphocyte ratio (NLR) shows promise as a predictive tool for severe scorpion envenomation in children.
- Initial hematological parameters, particularly NLR, can assist in stratifying risk and guiding clinical management decisions.
- Early identification of severe envenomation through NLR can potentially improve patient outcomes and resource allocation.
Background And Objectives:
Most cases of severe scorpion envenomation occur in children and are associated with significant morbidity and mortality. Excessive systemic inflammatory response, which leads to multiple organ involvement, is an emerging challenge during severe envenomation. The aim of this study was to investigate if there was any relationship between initial hematological parameters and severe envenomation in pediatric patients presenting with scorpion envenomation.
Method:
This study was performed retrospectively, at the pediatric emergency unit and pediatric intensive care unit of the Çukurova University Medical School in Turkey. Two hundred and fifty-seven cases with scorpion envenomation, and a control group consisting of one hundred and fifteen healthy children were included in the study.
Results:
White blood cell, neutrophil, lymphocyte, platelet, neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR) and PDW values of patients were higher than the controls (p < 0.05). Mean NLR was 3.8 ± 4.7 in patients. Patients were analyzed with the help of the decision tree model, and it was seen that in patients who had applied to hospital in less than an hour after the scorpion sting, 87.5% of the patients whose NLR value was between the 0.519-1.969 interval (below 2.1 which we found as the cut-off value) did not need to be hospitalized in the intensive care unit, 54.1% of the patients whose NLR value was higher than 1.969 needed to be hospitalized at the intensive care unit.
Conclusions:
Severe envenomation is associated with mortality and morbidity in children. Our findings showed that NLR seems to be a useful tool in predicting severe envenomation.
