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KMID : 1102220160350020102
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Kidney Research and Clinical Practice
2016 Volume.35 No. 2 p.102 ~ p.106
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Predicting the probability of survival in acute paraquat poisoning
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Sun In-O
Shin Sung-Hye
Yoon Hyun-Ju
Lee Kwang-Young
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Abstract
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Background: Paraquat (PQ) concentration?time data have been used to predict prognosis for 3?decades. The aim of this study was to find a more accurate method to predict the probability of survival.
Methods: This study included 788 patients with PQ poisoning who were diagnosed using plasma PQ concentration between January 2005 and August 2012. We divided these patients into 2 groups (survivors vs. nonsurvivors), compared their clinical characteristics, and analyzed the predictors of survival.
Results: The mean age of the included patients was 57 years (range, 14?95 years). When we compared clinical characteristics between survivors (n?=?149, 19%) and nonsurvivors (n?=?639, 81%), survivors were younger (47?±?14?years vs. 59?±?16?years) and had lower plasma PQ concentrations (1.44?±?8.77?μg/mL vs. 80.33?±?123.15?μg/mL) than nonsurvivors. On admission, serum creatinine was lower in survivors than in nonsurvivors (0.95?±?0.91?mg/dL vs. 1.88?±?1.27?mg/dL). In multivariate logistic regression analysis, age and logarithmically converted serum creatinine [ln(Cr)], [ln(time)], and [ln(PQ)] were assessed as prognostic factors to predict survival in PQ poisoning. The predicted probability of survival using significant prognostic factors was exp (logit)/[1?+?exp(logit)], where logit?=??1.347 +?[0.212?×?sex (male?=?1, female?=?0)]?+?(0.032?×?age)?+ [1.551?×?ln(Cr)] +?[0.391?×?ln(hours since ingestion)]?+?[1.076?×?ln(plasma PQ μg/mL)]. With this equation, the sensitivity and specificity were 86.5% and 98.7%, respectively.
Conclusion: Age, ln(Cr), ln(time), and ln(PQ) were important prognostic factors in PQ poisoning, and our equation can be helpful to predict the survival in acute PQ poisoning patients.
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KEYWORD
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Creatinine, Logistic models, Paraquat, Prognosis
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