Analysis of risk factors for prognoses of 176 patients with acute paraquat intoxication
10.3969/j.issn.1008-9691.2013.04.019
- VernacularTitle:176例急性百草枯中毒患者预后危险因素分析
- Author:
Jinzhu WANG
;
Chao LAN
;
Li LI
;
Changhua SUN
- Publication Type:Journal Article
- Keywords:
Toxication;
Paraquat;
Prognosis;
Risk factor
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2013;(4):240-243
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors influencing the prognoses by analyzing clinical data of patients with acute paraquat intoxication,and provide a basis for clinical prevention and treatment of the disease. Methods The clinical data of 176 patients with acute paraquat intoxication admitted into our Hospital were retrospectively collected during the period from January 2012 to February 2013. After admission,the conventional medical treatment was given to all the patients,and according to the prognoses of 28 days after poisoning,the patients were divided into death group and survival group. The gender,age,toxic dose,time elapsed from poisoning to admission,time elapsed from poisoning to gastric lavage,number of cases treated with drug lavage,white blood cell count(WBC),alanine amino-transferase(ALT),aspartate amino-transferase(AST),blood urea nitrogen(BUN), serum creatinine(SCr),acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ)score,carbon dioxide combining power(CO2CP),number and time of cases revealing arterial blood oxygen saturation(SaO2)<0.90, and the survival rate within 28 days after admission were recorded. Multivariate logistic regression was used to analyze the factors related to the prognosis. Results ①Of the 176 cases,96 survived and 80 died in 28 days,the survival rate being 54.55%.②Univariate analysis showed the poisoning dose(ml),time elapsed from poisoning to admission (minute), WBC(×109/L), ALT(U/L),AST(U/L),BUN(mmol/L),SCr(μmol/L),APACHEⅡ scores, CO2CP (mmol/L),number of cases with SaO2<0.90 in the survival group were significantly lower than those in the death group〔38.14±39.44 vs. 88.50±58.79,41.11±30.29 vs. 90.00±59.31,11.78±3.61 vs. 16.13±5.02,84.46±42.53 vs. 156.35±76.62,76.21±38.69 vs. 184.00±86.48,5.34±2.89 vs. 10.51±6.80,84.17±77.38 vs. 199.74±162.13, 0.96±1.60 vs. 3.60±2.61,22.02±4.47 vs. 18.35±4.19,4(4.17%)vs. 80(100.00%),respectively,all P<0.01〕;there were no statistically significant differences in time elapsed from poisoning to admission(hour),number of cases treated with drug lavage and time of revealing SaO2<0.90(day)between survival group and death group〔7.96±3.39 vs. 8.05±4.26, 20(20.83%)vs. 24(30.00%), 62.25±18.45 vs. 65.70±45.10,respectively,all P>0.05〕.③Multivariate logistic regression revealed poisoning doses>30 ml〔odds ratio(OR)=6.455,95% confidence interval(95%CI)3.177-13.113,P<0.001〕,time elapsed from poisoning to admission>30 minutes(OR=8.639, 95%CI 4.043-18.461, P<0.001), WBC>12×109/L (OR=2.745,95%CI 1.388-5.426, P=0.004),BUN>8 mmol/L(OR=6.713,95%CI 2.650-17.006,P<0.001)and CO2CP≤22 mmol/L(OR=4.737,95%CI 2.389-9.394, P<0.001) were the risk factors correlated with the prognosis of patients with acute paraquat intoxicationl. Conclusion Poisoning doses,time elapsed from poisoning to admission,BUN,CO2CP and WBC are the independent risk factors for predicting prognosis of acute paraquat intoxication.
