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KMID : 1013220230210020135
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Jouranl of the Korean Society of Clinical Toxicology
2023 Volume.21 No. 2 p.135 ~ p.142
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Utility of the APACHE II score as a neurological prognostic factor for glufosinate-intoxicated patients with alert mental status
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Lee Rok
Shin Tae-Yong
Moon Hyung-Jun
Lee Hyun-Jung
Jeong Dong-Kil
Lee Dong-Wook
Hong Sun-In
Kim Hyun-Joon
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Abstract
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Purpose: In patients with glufosinate poisoning, severe neurological symptoms may be closely related toa poor prognosis, but their appearance may be delayed. Therefore, this study aimed to determine whetherthe Acute Physiology and Chronic Health Evaluation II (APACHE II) score could predict the neurologicalprognosis in patients with glufosinate poisoning who present to the emergency room with alert mentalstatus.
Methods: This study was conducted retrospectively through a chart review for patients over 18 yearswho presented to a single emergency medical center from January 2018 to December 2022 due to glu fosinate poisoning. Patients were divided into groups with a good neurological prognosis (Cerebral Per formance Category [CPC] Scale 1 or 2) and a poor prognosis (CPC Scale 3, 4, or 5) to identify whether anyvariables showed significant differences between the two groups.
Results: There were 66 patients (67.3%) with good neurological prognoses and 32 (32.8%) with poorprognoses. In the multivariate logistic analysis, the APACHE II score, serum amylase, and co-ingestion ofalcohol showed significant results, with odds ratios of 1.387 (95% confidence interval [CI], 1.027?1.844),1.017 (95% CI, 1.002?1.032), and 0.196 (95% CI, 0.040?0.948), respectively. With an APACHE II scorecutoff of 6.5, the AUC was 0.826 (95% CI, 0.746?0.912). The cutoff of serum amylase was 75.5 U/L, withan AUC was 0.761 (95% CI, 0.652?0.844), and the AUC of no co-ingestion with alcohol was 0.629 (95%CI, 0.527?0.722).
Conclusion: The APACHE II score could be a useful indicator for predicting the neurological prognosis ofpatients with glufosinate poisoning who have alert mental status.
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KEYWORD
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Phosphinothricin, Herbicides, APACHE, Prognosis
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