급성 파라콰트(paraquat) 중독의 조기 예후 예측인자: 602예 분석

Abstract

BACKGROUND: Acute paraquat poisoning has been notorious for fatal outcome. Even though many studies focus on successful treatment modality, there is no standard treatment so far. The purpose of this study was to determine the predictors of successful outcome of acute paraquat poisoning in 602 patients. METHODS: The paraquat exposure was assessed based on the estimated amount of paraquat and a semi-quantitative measure of urine paraquat. Initial laboratory parameters including hemoglobin, white blood cell count, pH, PaCO2, PaO2, blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, total bilirubin, amylase, lipase, and glucose were obtained at the time of emergency room visit. Outcomes after acute paraquat poisoning were determined as survival and death. Multiple logistic regression analysis was applied to assess the predictors of outcome after acute paraquat poisoning. RESULTS: The estimated amount of paraquat was 45.6+/-74.1 mL and overall mortality after acute paraquat poisoning was 41.5%, whereas all were survived after skin contact or inhalation of paraquat. In multiple logistic regression analysis, death after acute paraquat poisoning increased significantly with the decreases in pH and PaCO2 and increases in white blood cell count, amylase, lipase, glucose, and paraquat exposure. CONCLUSION: In conclusion, percutaneous or inhalational route, smaller exposure of paraquat, and lesser degrees of leukocytosis, acidosis, pancreatic failures on admission are good prognostic factors of survival after acute paraquat poisoning.