Arterial lactate as a predictor of mortality in emergency department patients with paraquat intoxication

Lee, Young Hwan; Lee, Jun Ho; Seong, Ae Jin; Hong, Chong Kun; Lee, Hae Jong; Shin, Dong Hyuk; Hwang, Seong Youn

doi:10.3109/15563650.2011.639716

Cited by 45 publications

(38 citation statements)

References 24 publications

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“…Plasma PQ concentration and creatinine level at admission are important prognostic markers [13]. Some oxidative stress markers have been investigated by our group and in other reports [14]–[19], but it is doubtful that these markers would be superior to plasma PQ concentration. In addition, although these markers may be involved in the pathogenesis in PQ injury, they are not useful in the clinical situation because they require expensive laboratory capabilities.…”

Section: Discussionmentioning

confidence: 90%

Prediction of Patient Survival in Cases of Acute Paraquat Poisoning

et al. 2014

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Paraquat concentration-time data have been used to predict the clinical outcome following ingestion. However, these studies have included only small populations, although paraquat poisoning has a very high mortality rate. The purpose of this study was to develop a simple and reliable model to predict survival according to the time interval post-ingestion in patients with acute paraquat poisoning. Data were retrospectively collected for patients who were admitted with paraquat poisoning to Soonchunhyang University Choenan Hospital between January 2005 and December 2012. Plasma paraquat levels were measured using high-performance liquid chromatography. To validate the model we developed, we used external data from 788 subjects admitted to the Presbyterian Medical Center, Jeonju, Korea, between January 2007 and December 2012. Two thousand one hundred thirty six patients were included in this study. The overall survival rate was 44% (939/2136). The probability of survival for any specified time and concentration could be predicted as (exp(logit))/(1+exp(logit)), where logit = 1.3544+[−3.4688×log10(plasma paraquat μg/M)]+[−2.3169×log10(hours since ingestion)]. The external validation study showed that our model was highly accurate for the prediction of survival (C statics 0.964; 95% CI [0.952–0.975]). We have developed a model that is effective for predicting survival after paraquat intoxication.

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Section: Discussionmentioning

confidence: 90%

Prediction of Patient Survival in Cases of Acute Paraquat Poisoning

et al. 2014

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“…To date, several diagnostic methods have been developed to evaluate the severity of acute PQ poisoning in patients, including urine PQ concentration, the Acute Physiology and Chronic Health Evaluation (APACHE) II score, arterial blood lactate and ingestion dose of PQ (9,10). Plasma and urine PQ concentrations obtained within the first 24 h after ingestion are excellent predictors of the outcomes of PQ poisoning (2).…”

Section: Introductionmentioning

confidence: 99%

Predictive values of urine paraquat concentration, dose of poison, arterial blood lactate and APACHE II score in the prognosis of patients with acute paraquat poisoning

Liu

et al. 2017

Experimental and Therapeutic Medicine

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The present study investigated the predictive values of urine paraquat (PQ) concentration, dose of poison, arterial blood lactate and Acute Physiology and Chronic Health Evaluation (APACHE) II score in the prognosis of patients with acute PQ poisoning. A total of 194 patients with acute PQ poisoning, hospitalized between April 2012 and January 2014 at the First Affiliated Hospital of P.R. China Medical University (Shenyang, China), were selected and divided into survival and mortality groups. Logistic regression analysis, receiver operator characteristic (ROC) curve analysis and Kaplan-Meier curve were applied to evaluate the values of urine paraquat (PQ) concentration, dose of poison, arterial blood lactate and (APACHE) II score for predicting the prognosis of patients with acute PQ poisoning. Initial urine PQ concentration (C0), dose of poison, arterial blood lactate and APACHE II score of patients in the mortality group were significantly higher compared with the survival group (all P<0.05). Logistic regression analysis revealed that C0, dose of poison and arterial blood lactate correlated with mortality risk of acute PQ poisoning (all P<0.05). ROC curve analysis suggested that the areas under the curve (AUC) values of C0, dose of poison, arterial blood lactate and APACHE II score in predicting the mortality of patients within 28 days were 0.921, 0.887, 0.808 and 0.648, respectively. The AUC of C0 for predicting early and delayed mortality were 0.890 and 0.764, respectively. The AUC values of urine paraquat concentration the day after poisoning (Csec) and the rebound rate of urine paraquat concentration in predicting the mortality of patients within 28 days were 0.919 and 0.805, respectively. The 28-day survival rate of patients with C0 ≤32.2 µg/ml (42/71; 59.2%) was significantly higher when compared with patients with C0 >32.2 µg/ml (38/123; 30.9%). These results suggest that the initial urine PQ concentration may be the optimal index for predicting the prognosis of patients with acute PQ poisoning. Additionally, dose of poison, arterial blood lactate, Csec and rebound rate also have referential significance.

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“…Evaluation of the blood lactate level is generally used in diagnosis and management of the patients with signs and symptoms of sepsis or shock and is a sign of tissue hypoperfusion (Kompanje et al, 2007). The role of blood lactate level has been studied as a prognostic factor in drug and chemical poisoning too (Dell'Aglio et al, 2009;Seidowsky et al, 2009;Manini et al, 2010;Mégarbane et al, 2010;Inoue et al, 2008;Lee et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Lactate and creatine phosphokinase as potential independent predictors of organophosphrus poisoning severity in Zagazig University Hospital Patients, Egypt

Arafa¹,

Shalaby²,

Atteia³

2017

J. Toxicol. Environ. Health Sci.

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This study aimed to assess the correlation of serum lactate and creatine phosphokinase (CPK) levels, and their association with severity of organophosphrus poisoning in order to use one of them or both as tools in predicting prognosis. This study was conducted over one year and 68 organophosphate (OP)-poisoned patients were enrolled. Clinical severity of cases was categorized according to Peradeniya organophosphorus poisoning (POP) scale. Levels of serum acetyl choline esterase (AChE), serum CPK and serum lactate were measured on admission (0 h), 6 and 24 h post-ingestion. The results showed a high statistically significant difference between cases and control regarding AChE, CPK and lactate on admission. Also, there was high statistically significant difference regarding AChE, CPK and lactate among different categories of cases on admission, 6 and 24 h post admission. In addition, there was a statistically significant increase among different categories of POP scale regarding the quantity of atropine used in management of cases. Regarding oximes and stay in ICU, there was a statistically significant increase in severe poisoned patients when compared with moderate poisoned ones. A significant negative correlation was observed between AChE and severity of poisoning as well as significant positive correlation between CPK and lactate. It is concluded that serum CPK and serum lactate can be used as predictor of outcomes in OP poisoning and helps in determining cases that need follow up. Serum CPK and serum lactate can be used as predictors of outcomes in OP poisoning and helping in determining the cases that need follow up.

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Arterial lactate as a predictor of mortality in emergency department patients with paraquat intoxication

Cited by 45 publications

References 24 publications

Prediction of Patient Survival in Cases of Acute Paraquat Poisoning

Prediction of Patient Survival in Cases of Acute Paraquat Poisoning

Predictive values of urine paraquat concentration, dose of poison, arterial blood lactate and APACHE II score in the prognosis of patients with acute paraquat poisoning

Lactate and creatine phosphokinase as potential independent predictors of organophosphrus poisoning severity in Zagazig University Hospital Patients, Egypt

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