Prediction of Patient Survival in Cases of Acute Paraquat Poisoning

Abstract

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.

Effect of MDR1 gene polymorphisms on mortality in paraquat intoxicated patients

“…Baseline laboratory parameters and initial patient information recorded at hospital arrival are summarized in Table 2. Overall mortality rate was 66.1%, similar to the mortalities rates in previous studies123. Semi-quantitative dithionite tests revealed that 27 patients had grade 1+ (blue color), 22 patients had grade 2+ (tender blue), and 60 patients had grade 3+ (dark blue) paraquat levels.…”

Investigating global trends in paraquat intoxication research from 1962 to 2015 using bibliometric analysis

“…Over the last decade (2006‐2015), marked progress has been made in the area of paraquat intoxication research. Clinical toxicology research on paraquat intoxication increased rapidly in this decade, and these clinical studies provide evidence of increased risk of mortality, the association between plasma paraquat level and outcome of paraquat poisoning, immunosuppressive therapy in lung fibrosis, and early haemoperfusion and the improvement of survival chances of severely paraquat‐poisoned patients …”

Abnormal pancreatic enzymes and their prognostic role after acute paraquat poisoning

“…The most powerful model of the three was composed of serum paraquat level and the ingestion time. But the limitations of the study were its retrospective design and the uneasy reach of serum paraquat test in clinical practice 39 .…”

“…In view of the unstable power of the single factors and the complex of the traditional scores, and different from most of the above retrospective study, our report is prospective design and our model is based on the most routine test in clinical work 39 .…”