Abstract
This retrospective and a single-center study evaluated the prognostic value of the maximum serum creatinine value (maxCr) and the maximum serum creatinine growth rate (Vmax) after paraquat (PQ) ingestion. One hundred and seventy-one patients with PQ poisoning were treated with a uniform protocol. Demographic variables, clinical manifestations, relevant laboratory data, maxCr and Vmax of all patients were recorded and calculated. The time after PQ ingestion of maxCr and Vmax were also recorded. Vmax and MaxCr exhibited statistically significant differences between the survivor (n = 53) and death (n = 118) groups. Vmax appeared earlier in the death group than the survivor group. Regard to the receiver operating characteristic (ROC) curve analysis, Vmax had an AUC of 0.861 (95% CI, 0.801–0.921) and the optimal cut-off value of 6.21 μmol/(L·h) (sensitivity, 76.3%; specificity, 81.1%). MaxCr had an area under the curve (AUC) of 0.821 (95% CI, 0.752–0.889) and the optimal cut-off value of 225.5 µmol/L (sensitivity, 82.2%; specificity, 67.9%). The comparison of the AUC in the two parameters showed no significant difference, but Vmax appeared earlier than maxCr. Based on binary logistic regression analysis, MaxCr and Vmax both showed strong predictive powers for evaluating the prognosis of acute PQ poisoning patients.
Highlights
Paraquat (PQ) is a non-selective contact herbicide which has been world-widely used for many years, especially in the developing agricultural countries, including China
Several prognostic predictors have been reported to predict the outcome of acute PQ poisoning, such as patients’ plasma or urine PQ concentration, arterial lactate, abnormal pancreatic enzymes, hematological parameters, PQ ingestion volume, acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score[8,9,10,11,12,13,14,15,16,17,18,19]
The prognostic values of the maximum serum creatinine value and the maximum serum creatinine growth rate (Vmax) after PQ poisoning, in order to evaluate whether these two indicators could be alternative predictive markers
Summary
Paraquat (PQ) is a non-selective contact herbicide which has been world-widely used for many years, especially in the developing agricultural countries, including China. Several prognostic predictors have been reported to predict the outcome of acute PQ poisoning, such as patients’ plasma or urine PQ concentration, arterial lactate, abnormal pancreatic enzymes, hematological parameters, PQ ingestion volume, acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score[8,9,10,11,12,13,14,15,16,17,18,19] These indicators above have deficiencies to accurately predict prognosis, because of the limited availability and reliability. The prognostic values of the maximum serum creatinine value (maxCr) and the maximum serum creatinine growth rate (Vmax) after PQ poisoning, in order to evaluate whether these two indicators could be alternative predictive markers
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