Association between leukocytosis and adverse clinical outcomes in thrombocytopenic patients with acute pesticide poisoning: a cross-sectional study from a referral poisoning center in Iran

This study evaluated the association between leukocytosis and adverse clinical outcomes in patients with pesticide poisoning who also had thrombocytopenia. This cross-sectional study used medical records of patients who presented between 2016 and 2021, including 241 adult patients with confirmed pesticide poisoning. We extracted demographic data, clinical signs, laboratory parameters, and outcomes. We categorized hospitalization duration as >72 hours, 24-72 hours, and <24 hours. Leukocytosis was present in 43.2% of patients (n = 104). The overall mortality rate was 25.3% (n = 61), with 49.8% requiring intensive care unit (ICU) admission (n = 120) and 44.4% requiring intubation (n = 107). Patients with elevated WBC had higher odds of prolonged hospitalization than those with normal counts: OR = 3.36, p = 0.004 for 24-72 h; and OR = 4.63, p < 0.001 for hospitalizations longer than 72 h. Leukocytosis was also strongly associated with intubation (OR = 3.50, p < 0.001) and ICU admission (OR = 3.58, p < 0.001). After adjustment, only ICU admission and leukocytosis remained significantly associated (OR = 2.20, p = 0.024). Leukocytosis may be a valuable parameter in predicting ICU admission and hospitalization duration in thrombocytopenic patients with acute pesticide poisoning. Further prospective multicenter studies are needed.