Bleeding Profile as a Prognostic Indicator in Hepatotoxic Rodenticide Poisoning: A Cross-Sectional Study
Authors/Creators
- 1. Assistant Professor, Department of Emergency Medicine, Government Medical College, Surat
- 2. 3rd Year Resident, Department of General Medicine, Government Medical College, Surat
- 3. Senior Resident, Department of Emergency Medicine, Government Medical College, Surat
- 4. Assistant Professor, Department of Radiology, Government Medical College, Surat
- 5. Senior Consultant and Head, Department of GI Surgery, Aryavart Hospital, Meerut
- 6. Professor, Department of Physiology, Pacific Medical College & Hospital, Udaipur
Description
Background: Hepatotoxic rodenticide poisoning, particularly from yellow phosphorus, is a major public health concern, especially in developing countries. The role of coagulation abnormalities, such as activated partial thromboplastin time (aPTT) and international normalized ratio (INR), in predicting outcomes in these cases remains underexplored. This study aims to evaluate the prognostic significance of these bleeding profile parame-ters in hepatotoxic rodenticide poisoning. Methods: A cross-sectional study was conducted at New Civil Hospital, Surat, India, from ethical clearance to May 2024. Seventy patients, aged 18 years or older, with a history of rodenticide poisoning and confirmed hepatotoxicity, were included. Patients were classified based on mortality and morbidity outcomes. Bleeding profile parameters, including aPTT and INR, were analyzed for their association with clinical outcomes. Results: Of the 70 patients, 11 (15.7%) died, and 59 (84.3%) recovered. A total of 38 (54.2%) required ICU admission due to severe illness. Elevated aPTT levels were significantly associated with morbidity, with 88% of severely ill patients showing elevated levels (p < 0.00001), while no significant association was found with mortality (p = 0.51883). Similarly, elevated INR levels were significantly correlated with morbidity (52.6% of severely ill patients, p = 0.00012), but not with mortality (p = 0.18110). Conclusion: While serum aPTT and INR levels are not reliable predictors of mortality in hepatotoxic rodenti-cide poisoning, they are significantly associated with morbidity, particularly the need for ICU admission. These parameters can assist in identifying patients at higher risk for severe illness but should be considered alongside other clinical indicators for comprehensive prognosis. Further studies with larger sample sizes and additional biomarkers are warranted to refine prognostic models.
Abstract (English)
Background: Hepatotoxic rodenticide poisoning, particularly from yellow phosphorus, is a major public health concern, especially in developing countries. The role of coagulation abnormalities, such as activated partial thromboplastin time (aPTT) and international normalized ratio (INR), in predicting outcomes in these cases remains underexplored. This study aims to evaluate the prognostic significance of these bleeding profile parame-ters in hepatotoxic rodenticide poisoning. Methods: A cross-sectional study was conducted at New Civil Hospital, Surat, India, from ethical clearance to May 2024. Seventy patients, aged 18 years or older, with a history of rodenticide poisoning and confirmed hepatotoxicity, were included. Patients were classified based on mortality and morbidity outcomes. Bleeding profile parameters, including aPTT and INR, were analyzed for their association with clinical outcomes. Results: Of the 70 patients, 11 (15.7%) died, and 59 (84.3%) recovered. A total of 38 (54.2%) required ICU admission due to severe illness. Elevated aPTT levels were significantly associated with morbidity, with 88% of severely ill patients showing elevated levels (p < 0.00001), while no significant association was found with mortality (p = 0.51883). Similarly, elevated INR levels were significantly correlated with morbidity (52.6% of severely ill patients, p = 0.00012), but not with mortality (p = 0.18110). Conclusion: While serum aPTT and INR levels are not reliable predictors of mortality in hepatotoxic rodenti-cide poisoning, they are significantly associated with morbidity, particularly the need for ICU admission. These parameters can assist in identifying patients at higher risk for severe illness but should be considered alongside other clinical indicators for comprehensive prognosis. Further studies with larger sample sizes and additional biomarkers are warranted to refine prognostic models.
Files
IJPCR,Vol16,Issue12,Article54.pdf
Additional details
Dates
- Accepted
-
2024-11-25
Software
- Repository URL
- http://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue12,Article54.pdf
- Development Status
- Active
References
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