Increased plasma prothrombin time is associated with poor prognosis in patients with paraquat poisoning.

Abstract

Paraquat can cause severe injury to vascular endothelial cells and lead to coagulation dysfunction when it is taken into the blood by oral ingestion. In this study, we aim to find a routine coagulation index to serve as an indicator of outcome in patients with acute paraquat poisoning. Between January 2012 and December 2016, 209 patients who attempted suicide by oral ingestion of paraquat were admitted to the emergency room. Routine coagulation indices, including plasma prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fbg), thrombin time (TT), and D-dimer were measured to analyze the trend of changes and their relationship with prognosis. The results showed that the PT and APTT values in the ≥30mL group were significantly greater than those in the <30mL group (both P<.01). Within 1week of admission, PT and APTT values gradually decreased, while Fbg levels gradually increased. Univariate and multivariate Cox regression analysis indicated that sex, ingestion volume, and PT were independent predictors of mortality within 40days. The cumulative survival rates differed significantly (P=.001) between patients with PT <12seconds and PT ≥12seconds. Coagulation status in patients with PQ poisoning was closely related to prognosis. Routine monitoring of coagulation function, particularly PT in plasma, is helpful for analysis of the condition and prognosis of patients with PQ poisoning.