Predictive value of white blood cell and neutrophil count on the survival status of patients with diquat poisoning after discharge

ObjectiveTo explore the clinical characteristics and prognostic factors of diquat (DQ) poisoning patients, and evaluate the predictive value of white blood cell (WBC) and neutrophil count on the survival status of DQ poisoning patients after discharge.

MethodsAccording to the survival status after discharge, 41 patients with DQ poisoning were divided into survival group (n=30) and death group (n=11).The clinical and laboratory index of the two groups were analyzed.The influencing factors of patients' prognosis were analyzed by logistic regression.ROC curve was used to evaluate the predictive value of WBC and neutrophil count 24 h after poisoning on the survival status of patients with DQ poisoning.In addition, the levels of WBC and neutrophil count at 24 h and 72 h after poisoning in the two groups were analyzed to evaluate the possible correlation between the dynamic changes of WBC and neutrophil count and the discharge survival status of DQ poisoning patients.

ResultsThe age, body mass index, toxic dose and the proportion of mechanical ventilation in the death group were significantly higher than those in the survival group, while the proportion of CRRT and the length of hospital stay were significantly lower than those in the survival group (P < 0.01).The levels of WBC and neutrophil count 24 h after poisoning in the death group were significantly higher than the survival group (P < 0.01).Logistic regression analysis showed that except for the poisoning dose, the value of variables with significant differences in group comparison was obvious (P < 0.05).After adding gender and age as adjustment variables, the results of logistic regression analysis showed that only the length of hospital stay, mechanical ventilation or not, WBC and neutrophil count 24 h after poisoning were significant (P < 0.05).The ROC curve analysis showed that when 11.765×10⁹/L and 29.345×10⁹/L were used as cutoff values of the neutrophil count and WBC 24 h after poisoning respectively, the maximum area under the curve can be obtained (AUC: 0.816±0.080, 95%CI: 0.660-0.973, P < 0.01 and AUC: 0.783±0.088, 95%CI: 0.611-0.955, P < 0.05).The levels of WBC and neutrophil counts in the survival group at 72 hours after poisoning were significantly lower than those at 24 h after poisoning (P < 0.05).By contrast, the average levels of WBC and neutrophil count in the death group at 72 hours after poisoning were also lower than that at 24 h after poisoning, but the difference was not significant.

ConclusionsWBC and neutrophil count in patients with DQ poisoning 24 hours after poisoning can be used as effective factors to predict their survival after discharge, and the dynamic monitoring of WBC and neutrophil count is helpful to determine the adverse prognosis of patients with DQ poisoning.