Prognostic significance of urine paraquat concentrations of patients with acute paraquat poisoning on admission at the emergency department

Abstract

Objective: To assess the prognostic significance of urine paraquat concentrations of patients with acute paraquat poisoning on admission at the emergency department. Methods: Patients with acute paraquat poisoning admitted to the emergency department were recruited. Survivors and non-survivors were compared with regard to urinary paraquat concentration. The urinary level predictive of mortality was assessed by receiver operating characteristic curve. Risk factors of mortality were evaluated by regression analysis. Results: The overall mortality rate was 70.9% over the 28-day follow-up period. There was a significant difference in the urine paraquat concentrations recorded on admission between non-surviving and surviving patients (p = 0.022). Receiver operating characteristic curve analysis revealed that the area under the curve when applied to receiver operating characteristic of the admission urine paraquat concentrations for predicting mortality was 0.854 with a cutoff value of 34.5 µg/mL. The dose of paraquat ingested, arterial lactate, and urine concentration were independent risk factors predicting 28-day mortality. The time interval between ingestion and hemoperfusion, arterial lactate, and urine concentration of paraquat were independent risk factors predicting acute kidney injury, while the partial pressure of carbon dioxide (PaCO2) and urine concentration of paraquat were independent risk factors predicting acute lung injury. Conclusion: The urine concentrations of paraquat on admission at emergency department demonstrated predictive ability for the prognosis of patients with acute paraquat poisoning.