Prediction of early mortality in patients with paraquat intoxication

Abstract

Objective: Paraquat intoxication has a high mortality rate. The purpose of this study is to identify the clinical features and predictors of early mortality within 72 hours among individuals with paraquat intoxication in central Taiwan.Methods: This retrospective study included 92 patients who presented with paraquat intoxication at the emergency department (ED) of a medical center between January 2004 and December 2009. The patient characteristics, clinical features and outcomes of these patients are presented. Early mortality was defined as survival of less than 72 hours. The variables and predictors leading to early mortality were also analyzed. Results: Patients who survived over 72 hours were significantly younger and had ingested less paraquat than those who survived less than 72 hours. Elevated blood creatinine and decreased blood potassium levels in the ED were strong predictors of survival for less than 72 hours. In the first 12 hours after arriving at the ED, patients with early mortality had higher initial heart rates and mean arterial blood pressures than those who survived for more than 72 hours. The presence of systemic inflammatory response syndrome, and decreased heart and kidney function were significantly associated with early mortality (all were p < 0.05). Conclusion: The presence of systemic inflammatory response syndrome, early tachycardia and renal failure predicted early mortality.

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

“…Table demonstrates the total number and fatality rate data for paraquat poisoning in the 10 countries with the most published papers. Very high fatality rates were in Asia, including Japan (78.6%) and Taiwan (67.4%) . In addition, it is apparent from this table that paraquat is banned in the UK and the Europe countries (France, Germany, Spain, and Italy) since 2007, and in South Korea since 2012 .…”

The value of APACHE II in predicting mortality after paraquat poisoning in Chinese and Korean population

“…1 ). Ten studies were published in English [ 8 , 11 , 19 – 26 ] and 19 studies were published in Chinese, [ 27 – 45 ] as shown in Table 1 . Twenty-seven studies were conducted in Chinese and 2 studies in Korean.…”

“…The treatment of PQ intoxication has evolved over years, and this might have affected the observed outcomes. [ 26 ]…”

“…Self-reporting of the time and relative amount of PQ ingested might be underreported and inaccurate. [ 26 ] Although good predictive value was shown, the accuracy of the APACHE II score for predicting mortality was not very high. In addition to the variables noted for the APACHE II scoring system, other prognostic factors like arterial lactate levels [ 21 , 41 , 51 ] and pancreatic enzyme levels [ 25 , 52 ] also exhibited predictive value for mortality.…”

Prevention of Lung Complications following Paraquat Poisoning by Silymarin, N-acetyl Cysteine and Hydrocortisone: An Experimental Study

“…If not regulated properly, the excess ROS can impair the cellular lipids, proteins, and/ or DNA, inhibiting their normal functions [5]. The secondary effects of oxidative stress include lipid peroxidation, mitochondrial toxicity, oxidation of Nicotinamide Adenine Dinucleotide Phosphate (NADP), apoptosis and activation of nuclear factor kappa B [6]. These effects induce the formation of inflammatory enzymes, cytokines, and chemokines.…”