Monocytes as an Early Predictor for Patients with Acute Paraquat Poisoning: A Retrospective Analysis

Abstract

Background. The predictive values of monocytes in the prognosis of patients with acute paraquat (PQ) poisoning are unclear. This retrospective study investigated the predictive values of monocytes in the prognosis of patients with acute PQ poisoning. Methods. Adult patients who suffered from acute PQ poisoning in the emergency care unit of Cangzhou Central Hospital from May 2012 to December 2018 were enrolled. The patients were divided into groups, namely, survival and nonsurvival, according to a 90-day prognosis. Moreover, correlation, logistic regression, receiver-operator characteristic (ROC), and Kaplan–Meier curve analyses were applied to evaluate the monocyte values used to predict the prognosis of patients with acute PQ poisoning. Result. Among the 109 patients, 45 survived within 90 days after the poisoning, resulting in a 41.28% survival rate. The monocyte count of the nonsurvivors was significantly higher than that of the survivors (P< 0.001). Correlation analysis showed that monocyte count positively correlated with plasma PQ concentration (r= 0.413; P< 0.001) and negatively correlated with survival time (r= 0.512; P< 0.001) and 90-day survival (r= 0.503; P< 0.001). Logistic regression analysis showed that elevated monocytes were the independent risk factors for the 90-day survival. The area under the ROC curve of the monocyte count used to predict the 90-day survival was 0.826 (95% CI: 0.751–0.904), the optimal cut-off was 0.51×109/L, sensitivity was 73.4%, and specificity was 86.7%. Conclusion. This study demonstrated that elevated monocyte count is a useful early predictor of 90-day survival in patients with acute PQ poisoning. However, further studies are warranted to draw firm conclusions.

Identify the Early Predictor of Mortality in Patients with Acute Paraquat Poisoning

“…The neutrophilic granulocyte ratio and leukocyte count reflect the immune status of the body. Several studies have shown that the immune system of patients was activated during the paraquat poisoning [ 9 , 10 ]. As expected, the neutrophilic granulocyte ratio and leukocyte count increased in both survivors and nonsurvivors ( Table 1 ).…”

Investigation of simple, objective, and effective indicators for predicting acute paraquat poisoning outcomes

“…Early renal dysfunction indicates severe disease and poor prognosis. Renal function is a key parameter in clinical practice to determine prognosis of PQ poisoning (Lee et al, 2002;Weng et al, 2017;Zhao et al, 2019). Some studies have pointed to urinary PQ as the most valuable indicator in estimating severity and prognosis at the time of admission (Liu et al, 2017b;Tan et al, 2013).…”

Alveolar–arterial partial pressure difference as an early predictor for patients with acute paraquat poisoning

“…We performed a 10-year, observational, retrospective analysis of all patients who were admitted to our hospital after drinking PQ pesticide and who had already been discharged from hospital or had died from 1 January 2009 to 31 December 2018. 12 All patients were admitted to the hospital in accordance with standard medical emergency procedures. 13 …”

“…Patients with acute PQ poisoning usually die within a few weeks after PQ ingestion. 12 Therefore, an effective treatment was described as patients who survived more than 3 months after PQ poisoning, had stable vital signs, and had no evidence of progressive organ failure (especially the kidneys and lungs). 13 We also determined survival using medical records or telephone follow-up.…”

“…Other major treatments used were fluid infusion and diuresis (furosemide 40-120 mg/day), anti-fibrosis (cyclophosphamide 0.2 g/day for 5-7 days for patients with severe lung injury), an immunosuppressant (methylprednisolone 240-500 mg/day for 10-14 days), and glutathione 2.0 g/day. 12 Statistical analysis. The data are shown as mean AE standard deviation.…”