Extracorporeal blood purification therapy for acute poisoning in Jiangsu Province, China: a cross-sectional, multicenter real-world study
10.3760/cma.j.issn.1671-0282.2025.03.013
- VernacularTitle:江苏省908例体外血液净化治疗急性中毒：一项横断面、多中心的真实世界研究
- Author:
Li QIAO
1
;
Jinsong ZHANG
;
Jianrong CHEN
;
Lijun LIU
;
Ping GENG
;
Hong SUN
;
Yeping DU
;
Zhiguang TIAN
;
Jianjun MA
;
Rushan YANG
;
Jiancheng DONG
;
Zheng QIN
;
Shanshan WU
;
Yumin PAN
;
Yigang WU
Author Information
1. 南京医科大学第一附属医院急诊与危重症医学科，南京 210029
- Keywords:
Acute poisoning;
Blood purification;
Continuous renal replacement therapy;
Hemoperfusion;
Mortality;
Length of stay
- From:
Chinese Journal of Emergency Medicine
2025;34(3):369-375
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the current application of blood purification in the treatment of acute poisoning within Jiangsu Province and to evaluate the impact of extracorporeal blood purification on the clinical outcomes of critically poisoned patients.Methods:This multicenter, cross-sectional real-world observational study followed patients presenting with poisoning to the emergency departments of nine hospitals in Jiangsu Province between June 2015 and May 2019. Data were collected on demographic characteristics, vital signs within the first hour of emergency presentation, treatment modalities, length of hospital stay, and survival outcomes. Clinical data from patients who underwent extracorporeal blood purification were compared with those who did not, using the Wilcoxon rank-sum test and Chi-square test.Results:A total of 4 178 poisoning cases were included between June 2015 and May 2019. Among them, 21.7% (908/4 178) received blood purification therapy, while 78.3% (3 270/4 178) did not. Hemoperfusion (90.4%) was the most frequently employed method, followed by continuous renal replacement therapy (CRRT) (4.4%). In combined blood purification modalities, 4.8% underwent hemoperfusion combined with CRRT, 0.1% received hemoperfusion with plasma exchange, and another 0.1% underwent hemoperfusion combined with both CRRT and plasma exchange. Among patients who underwent blood purification, pesticide poisoning was the most prevalent (76.3%), with the most common toxic agents being paraquat (23.7%), dichlorvos (8.7%), methamidophos (5.2%), omethoate (4.0%), and glyphosate (3.7%). Compared to the non-blood purification group, patients in the blood purification group were more likely to present within the first hour with a low Glasgow Coma Scale (GCS) score (3-8) (22.6% vs. 9.7%, P <0.05), low mean arterial pressure (8.0% vs. 3.2%, P <0.05), longer hospital stays [5(3,9) days vs. 2(1,4) days, P <0.05] and a higher in-hospital mortality rate (21.1% vs. 5.3%, P <0.05). Follow-up via telephone 28 days after discharge revealed a survival rate of 78.9%, with a mortality rate of 21.1% in the blood purification group. Conclusions:Hemoperfusion is the most commonly utilized blood purification technique for treating poisoning in Jiangsu Province, with pesticides being the primary toxic agents treated. Although the mortality rate is higher in the blood purification group, the intervention may still contribute to improved patient outcomes.
