Abstract
The present study retrospectively analyzed 170 patients diagnosed with paraquat (PQ) poisoning with the aim of clarifying whether the arterial lactate-time (arterial lactate concentration × time between ingestion and arterial lactate measurement) was a good predictor of mortality in patients with acute PQ poisoning. The results indicated that there was a positive correlation between the arterial lactate-time and PQ concentration-time (ρ=0.485). In addition, the arterial lactate-time data exhibited a similar discriminative power to the plasma PQ concentration-time data (z=0.712; P=0.864). For the receiver operating characteristic curve analysis, the lactate-time data had an area of 0.782 with a cut-off value of 11.95 mmol/l.h (sensitivity, 64.52%; specificity, 84.42%). To calculate the predicted probability of survival for any specified time and initial arterial lactate concentration, the following formula was derived based on the logistic regression coefficients: Logit(p) = 3.066 − 0.139 × (time lag following PQ ingestion) − 0.177 × (initial arterial lactate concentration); where the probability of survivors = 1/1 + e−logit(p). Therefore, the arterial lactate-time data exhibited a good predictive power for evaluating the prognosis of patients with acute PQ poisoning.
Highlights
Paraquat (PQ) is a widely‐used herbicide that has been shown to cause severe and often fatal pulmonary fibrosis in humans and laboratory animals in developing countries, such as China and Sri Lanka
The results indicated that increased lactate concentrations (OR, 0.838; 95% confidence interval (CI), 0.755‐0.930; P
To calculate the predicted probability of survival for any specified time and initial arterial lactate concentration, the following formula was derived based on the logistic regression coefficients: Logit(p) = 3.066 ‐ 0.139 x ‐ 0.177 x; where the probability of survival = 1/1 + e‐logit(p)
Summary
Paraquat (PQ) is a widely‐used herbicide that has been shown to cause severe and often fatal pulmonary fibrosis in humans and laboratory animals in developing countries, such as China and Sri Lanka. The measurement of plasma PQ concentration has been considered as a marker of severity and prognosis [1]. Patients with PQ levels lower than a line connecting concentrations of 2.0, 0.6, 0.3, 0.16 and 0.1 mg/ml at 4, 6, 10, 16 and 24 h, respectively, have been shown to survive [9]. Scherrmann et al identified that 30 survivors following PQ poisoning had plasma PQ levels of >C mg/ml, where C = 1/[0.471 x time (h) since ingestion x 1.302] [10]. The correlation between the urine PQ concentration and the time following ingestion has been used to evaluate the prognosis of patients with PQ intoxication [13]. Estimates on the amount ingested are often unobtainable or unreliable in a number of intoxicated patients
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