Abstract
Hyperuricemia is a strong and independent predictor of all-cause mortality in cardiovascular disease and has been found to play a role in diseases exacerbated by oxidative stress and inflammation. This study aimed to evaluate whether serum uric acid (UA) level is an indicator of outcome in patients with acute paraquat poisoning. A total of 205 subjects who had attempted suicide by oral ingestion of paraquat were admitted to the emergency room between January 2009 and June 2014. Initial serum UA level and other laboratory parameters were measured. A total of 66 patients died during the 30 days after admission, corresponding to a 32.2% cumulative incidence of mortality. UA levels were higher in non-survivors than survivors (P < 0.001) and 30-day mortality increased with increasing baseline serum UA level (P < 0.001). In a prediction analysis for 30-day mortality, the serum UA level had a cut-off concentration of 284 µmol/L in female patients and 352 µmol/L in male patients. Multivariate Cox proportional hazards regression analyses showed that white blood cell counts and UA were independent prognostic factors. In conclusion, we showed that serum UA may be an independent predictor of 30-day mortality in patients with paraquat poisoning.
Highlights
Various studies have shown that PQ primarily exerts its toxic effects through the redox cycle, which produces oxygen free radicals, leading to oxidative damage and eventual cell death[21,22,23]
Our study is one of the few performed to date addressing serum uric acid (UA) levels and laboratory parameters in a clinical context with relatively large sample size
Our results confirmed our hypothesis: 30-day mortality increased with progressively higher baseline serum UA level and increased UA level was found to be an independent prognostic factor in patients with acute PQ poisoning
Summary
This study aimed to evaluate whether serum uric acid (UA) level is an indicator of outcome in patients with acute paraquat poisoning. We showed that serum UA may be an independent predictor of 30-day mortality in patients with paraquat poisoning. Our previous study indicated increased XO activity accompanied by lipid peroxidation and reduced total antioxidant capacity in subjects with acute PQ poisoning[15]. Because of a lack of specific antidotes, the overall mortality from acute PQ poisoning is substantially high[20]. This raises the need to develop a valuable predictor for prognosis to guide future therapeutic intervention.
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