Evaluation of the role of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) time series as predictors of diagnosis and prognosis of hemotoxic snakebite

Abstract

Background

This study aimed to assess the predictive value of NLR, PLR, and MPV time series for diagnosis and prognosis of hemotoxic snakebite envenomation.

Methods

This is a prospective study among snakebite patients admitted to the Poison Control Center of Ain Shams University Hospitals and Assiut University Hospitals from the beginning of July 2019 to the end of October 2021. Patients were classified according to their clinical severity into three groups: mild, moderate, and severe.

Results

The maximum incidence of snakebite was found in males (95%) from rural areas (80%); at lower limbs (70%); at night (51%); and during the autumn season (43.3%). The admission NLR and PLR can predict hemotoxic snakebite envenomation with an AUC of 0.940 and 0.569. The combination of NLR with PLR can develop a more predominant prediction of snakebite envenomation with an area under the curve (AUC) of 0.979. Furthermore, higher admission NLR and PLR levels are associated with prolonged hospital stays.

Conclusion

While NLR and PLR levels may be helpful in the diagnosis of snakebite, MPV plays no part in the prognosis of snakebite patients. Serial NLR, PLR initially, at 24 hours, and predischarge can be used to evaluate the early treatment response.

Keywords:

• Snakebite
• neutrophil-to-lymphocyte ratio
• platelet-to-lymphocyte ratio
• mean platelet volume

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.