The Time between Paraquat Ingestion and a Negative Dithionite Urine Test in an Independent Risk Factor for Death and Organ Failure in Acute Paraquat Intoxication

Seok, Su-Jin; Kim, Young‐Hee; Gil, Hyo‐Wook; Song, Ho‐Yeon; Hong, Sae‐Yong

doi:10.3346/jkms.2012.27.9.993

Cited by 28 publications

(42 citation statements)

References 24 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, continuous venovenous haemodiafiltration was successfully used in the rescue of a patient with a high dose PQ exposure of 36.48 mg/kg 21 . Thus, more patients might be saved if PQ elimination or renal replacement therapy can be more efficiently administered a short time after poisoning.…”

Section: Discussionmentioning

confidence: 99%

Time-dependent haemoperfusion after acute paraquat poisoning

Wang

Pan

Shang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

Early haemoperfusion (HP) therapy has been found to be very effective in acute paraquat (PQ) poisoning, but the effective rescue window is still uncertain. Demographic data and the type of therapies administered of 621 patients were included as confounding factors in this retrospective study. After receiver operating characteristic curve analysis and intra-group/subgroup analysis, the initiation of glucocorticoid therapy within 3 hrs of exposure with a second treatment given <21 hrs after exposure, HP initiated within 4 hrs of exposure with a second treatment given <20 hrs after exposure, the appearance of pulmonary lesions ≤8 days after exposure and six other variables were used in a multiple analysis. The strength of positivity of the PQ urine test on admission, HP initiated within 4 hrs of exposure with a second treatment given <20 hrs after exposure, the appearance of pulmonary lesions ≤8 days after exposure, and stage III AKI on admission were independent factors of survival probability. HP therapy for acute PQ poisoning was the main therapeutic intervention investigated in this study. Outcomes were time dependent, and the crucial factor was the initiation of therapy within 4 hrs of PQ poisoning followed by a second treatment within 20 hrs.

show abstract

Section: Discussionmentioning

confidence: 99%

Time-dependent haemoperfusion after acute paraquat poisoning

Wang

Pan

Shang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…To date, no prognostic models have been prospectively validated because of issues in their development such as small sample size, differences in the degree of severity, and complicated exclusion criteria 24 . The urine dithionite test is a simple index for clinical diagnosis and prediction of prognosis of PQ poisoning; however, false results limit its usefulness 25 . Our study is one of the few performed to date addressing serum UA levels and laboratory parameters in a clinical context with relatively large sample size.…”

Section: Discussionmentioning

confidence: 99%

The significance of serum uric acid level in humans with acute paraquatpoisoning

Zhang

Zhao

Bai

et al. 2015

Sci Rep

View full text Add to dashboard Cite

Hyperuricemia is a strong and independent predictor of all-cause mortality in cardiovascular disease and has been found to play a role in diseases exacerbated by oxidative stress and inflammation. This study aimed to evaluate whether serum uric acid (UA) level is an indicator of outcome in patients with acute paraquat poisoning. A total of 205 subjects who had attempted suicide by oral ingestion of paraquat were admitted to the emergency room between January 2009 and June 2014. Initial serum UA level and other laboratory parameters were measured. A total of 66 patients died during the 30 days after admission, corresponding to a 32.2% cumulative incidence of mortality. UA levels were higher in non-survivors than survivors (P < 0.001) and 30-day mortality increased with increasing baseline serum UA level (P < 0.001). In a prediction analysis for 30-day mortality, the serum UA level had a cut-off concentration of 284 µmol/L in female patients and 352 µmol/L in male patients. Multivariate Cox proportional hazards regression analyses showed that white blood cell counts and UA were independent prognostic factors. In conclusion, we showed that serum UA may be an independent predictor of 30-day mortality in patients with paraquat poisoning.

show abstract

“…Early prognosis of PQ poisoning is significant for both patients and doctors [3]. Studies have shown that the mortality rate of PQ poisoning is highly correlated with ingested PQ amount or PQ concentrations in plasma and urine (within 4-24 hr elapsed from ingestion) [4,5]. Hsu et al [6] found that early haemoperfusion (HP) after PQ exposure may reduce the mortality specifically and that HP <4.0 or <5.0 hr can reduce the relative risk of mortality by approximately 81% or 51%, respectively.…”

Section: Paraquat (11mentioning

confidence: 99%

An Effective Machine Learning Approach for Prognosis of Paraquat Poisoning Patients Using Blood Routine Indexes

Chen

et al. 2016

Basic Clin Pharma Tox

View full text Add to dashboard Cite

The early identification of toxic paraquat (PQ) poisoning in patients is critical to ensure timely and accurate prognosis. Although plasma PQ concentration has been reported as a clinical indicator of PQ poisoning, it is not commonly applied in practice due to the inconvenient necessary instruments and operation. In this study, we explored the use of blood routine indexes to identify the degree of PQ toxicity and/or diagnose PQ poisoning in patients via machine learning approach. Specifically, we developed a method based on support vector machine combined with the feature selection technique to accurately predict PQ poisoning risk status, then tested the method on 79 (42 male and 37 female; 41 living and 38 deceased) patients. The detection method was rigorously evaluated against a real-world data set to determine its accuracy, sensitivity and specificity. Feature selection was also applied to identify the factors correlated with risk status, and the results showed that there are significant differences in blood routine indexes between dead and living PQ-poisoned individuals (p-value < 0.01). Feature selection also showed that the most important correlated indexes are white blood cell and neutrophils. In conclusion, the toxicity or prognosis of PQ poisoning can be preliminarily ascertained by blood routine testing without PQ concentration data, representing an additional tool and innovative approach to assess the prognosis of PQ poisoning.of the most commonly used herbicides in the world, is considerably more toxic to human beings than other herbicidal agents. Acute ingestion of 7-8 mL PQ can cause severe liver, lung and kidney issues and even heart failure leading to death [1]; the mortality of PQ poisoning is 60-70% [2]. Many people have been poisoned by PQ throughout many years and across the world, although the problem is especially serious in developing countries. Early prognosis of PQ poisoning is significant for both patients and doctors [3]. Studies have shown that the mortality rate of PQ poisoning is highly correlated with ingested PQ amount or PQ concentrations in plasma and urine (within 4-24 hr elapsed from ingestion) [4,5]. Hsu et al. [6] found that early haemoperfusion (HP) after PQ exposure may reduce the mortality specifically and that HP <4.0 or <5.0 hr can reduce the relative risk of mortality by approximately 81% or 51%, respectively.Although PQ concentration has proven effective in terms of PQ poisoning diagnosis and prognosis, it is seldom applied in clinics [7,8] because it must be determined by HPLC or LC-MS, which requires highly accurate equipment [9,10].Although sodium dithionite, sodium hydroxide and spectrophotometry can be used to determine PQ concentration, they are simple qualitative assays and cannot provide the accurate level of PQ concentration. Consequently, PQ concentration is generally not available as a routine test option in hospitals.The blood routine test (BRT), also named complete blood count, which includes many indexes such as white blood cell (WBC), red blo...

show abstract

The Time between Paraquat Ingestion and a Negative Dithionite Urine Test in an Independent Risk Factor for Death and Organ Failure in Acute Paraquat Intoxication

Cited by 28 publications

References 24 publications

Time-dependent haemoperfusion after acute paraquat poisoning

Time-dependent haemoperfusion after acute paraquat poisoning

The significance of serum uric acid level in humans with acute paraquatpoisoning

An Effective Machine Learning Approach for Prognosis of Paraquat Poisoning Patients Using Blood Routine Indexes

Contact Info

Product

Resources

About