Evaluation value of white blood cell count for the prognosis of patients with acute paraquat poisoning

Abstract

Objective To investigate the evaluation value of white blood cell count (WBC) for the prognosis of patients with acute paraquat (PQ) poisoning. Methods The clinical data of 661 patients with acute PQ poisoning admitted to the Emergency Department of the First Affiliated Hospital of Zhengzhou University from March 2013 to April 2017 were retrospectively analyzed. The general information of patients and biochemical indicators 24 hours after admission were collected. The in-hospital death were recorded and patients were followed up by telephone. According to the prognosis within 30 days after poisoning, the patients were divided into survival group and death group. Multivariate logistic regression analysis was used to analyze the independent risk factors of PQ poisoning, and the receiver operating characteristic curve (ROC) was drawn for prognosis evaluation. Results Among the 661 patients with acute PQ poisoning, 368 cases (55.7%) survived and 293 cases(44.3%) died. Multivariate logistic regression analysis showed that hospitalization days, dosage, duration of poisoning, urine PQ concentration, WBC, serum potassium and serum creatinine (Scr) were the independent risk factors. The ROC curve showed that the area under the ROC curve (AUC) of urine PQ concentration and WBC predicting the prognosis of patients with acute PQ poisoning were 0.897 [95%CI(0.873, 0.920), P<0.01], and 0.876 [95%CI(0.850, 0.902), P<0.01]. WBC≥15.35×109/L was used as the critical value for prognosis. The sensitivity and specificity of survival were 72.7% and 88.59%, respectively. Conclusions White blood cell count may be a powerful and simple predictor for prognosis of PQ. Key words: Poisoning; Paraquat; Prognosis; Risk factors; White blood cell count