Predicting the probability of survival in acute paraquat poisoning

Abstract

BackgroundParaquat (PQ) concentration–time data have been used to predict prognosis for 3 decades. The aim of this study was to find a more accurate method to predict the probability of survival.MethodsThis study included 788 patients with PQ poisoning who were diagnosed using plasma PQ concentration between January 2005 and August 2012. We divided these patients into 2 groups (survivors vs. nonsurvivors), compared their clinical characteristics, and analyzed the predictors of survival.ResultsThe mean age of the included patients was 57 years (range, 14–95 years). When we compared clinical characteristics between survivors (n = 149, 19%) and nonsurvivors (n = 639, 81%), survivors were younger (47 ± 14 years vs. 59 ± 16 years) and had lower plasma PQ concentrations (1.44 ± 8.77 μg/mL vs. 80.33 ± 123.15 μg/mL) than nonsurvivors. On admission, serum creatinine was lower in survivors than in nonsurvivors (0.95 ± 0.91 mg/dL vs. 1.88 ± 1.27 mg/dL). In multivariate logistic regression analysis, age and logarithmically converted serum creatinine [ln(Cr)], [ln(time)], and [ln(PQ)] were assessed as prognostic factors to predict survival in PQ poisoning. The predicted probability of survival using significant prognostic factors was exp (logit)/[1 + exp(logit)], where logit = –1.347 + [0.212 × sex (male = 1, female = 0)] + (0.032 × age) + [1.551 × ln(Cr)] + [0.391 × ln(hours since ingestion)] + [1.076 × ln(plasma PQ μg/mL)]. With this equation, the sensitivity and specificity were 86.5% and 98.7%, respectively.ConclusionAge, ln(Cr), ln(time), and ln(PQ) were important prognostic factors in PQ poisoning, and our equation can be helpful to predict the survival in acute PQ poisoning patients.

A CRISPR screen identifies a pathway required for paraquat-induced cell death

“…1a and Supplementary Results , Supplementary Fig. 1a ) and is similar to the plasma concentration observed in patients with acute PQ toxicity [ 11 , 19 ]. Human Jurkat T-acute lymphoblastic leukemia cells were transduced with a metabolic single guide RNA (sgRNA) library containing ~10 unique sgRNAs for each of the ~3,000 metabolic genes (~30,000 sgRNAs total) [ 20 ] and cultured in the presence or absence of 110 μM PQ for at least 10 days ( Supplementary Fig.…”

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

“…During this process, WBC, cytokines, and other inflammatory factors are produced, leading to acute lung injury and multi-organ dysfunction. Higher WBC count is associated with negative patient outcomes (Sun et al, 2016). We also found that WBC count at the time of admission was higher in the mortality group than that in the survival group in our study (p < 0.01).…”

“…However, PQ can directly attack the renal tubules, leading to renal damage or acute failure. This reduces PQ excretion, which causes an accumulation of PQ in the tissues and organs and increases body damage (Molck and Friis, 1998;Sun et al, 2016). Urea nitrogen and serum Cr levels increase during this process.…”

Does hemoperfusion in combination with other treatments reduce the mortality of patients with paraquat poisoning more than hemoperfusion alone: A systematic review with meta-analysis

“…We found 5 articles with a total of 1311 patients. [3839404142] Eight hundred and thirty-seven patients were underwent HP, of which 592 patients died (70.72%). Four hundred and seventy-four patients did not receive HP, of which 428 patients died (90.29%).…”