EurekaMag.com logo
+ Site Statistics
References:
53,517,315
Abstracts:
29,339,501
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on Google+Follow on Google+
Follow on LinkedInFollow on LinkedIn

+ Translate

Prediction of outcome after paraquat poisoning by measurement of the plasma paraquat concentration



Prediction of outcome after paraquat poisoning by measurement of the plasma paraquat concentration



Qjm 102(4): 251-259



Paraquat is a herbicide with a good occupational safety record, but a high mortality after intentional ingestion that has proved refractory to treatment. For nearly three decades paraquat concentration-time data have been used to predict the outcome following ingestion. However, none of the published methods has been independently or prospectively validated. We aimed to use prospectively collected data to test the published predictive methods and to determine if any is superior. Plasma paraquat concentrations were measured on admission for 451 patients in 10 hospitals in Sri Lanka as part of large prospective cohort study. All deaths in hospital were recorded; patients surviving to hospital discharge were followed up after 3 months to detect delayed deaths. Five prediction methods that are based on paraquat concentration-time data were then evaluated in all eligible patients. All methods showed comparable performance within their range of application. For example, between 4- and 24-h prediction of prognosis was most variable between Sawada and Proudfoot methods but these differences were relatively small [specificity 0.96 (95% CI: 0.90-0.99) vs. 0.89 (0.82-0.95); sensitivity 0.57 vs. 0.79, positive and negative likelihood ratios 14.8 vs. 7.40 and 0.44 vs. 0.23 and positive predictive values 0.96 vs. 0.92, respectively]. All five published methods were better at predicting death than survival. These predictions may also serve as tools to identify patients who need treatment and for some assessment to be made of new treatments that are trialled without a control group.

(PDF same-day service: $19.90)

Accession: 055104760

Download citation: RISBibTeXText

PMID: 19228776

DOI: 10.1093/qjmed/hcp006



Related references

Association between plasma paraquat level and outcome of paraquat poisoning in 375 paraquat poisoning patients. Clinical Toxicology 46(6): 515-518, 2008

The value of plasma paraquat concentration in predicting therapeutic effects of haemoperfusion in patients with acute paraquat poisoning. Plos One 7(7): E40911-E40911, 2013

Rapid analysis of plasma paraquat using sodium dithionite as a predictor of outcome in acute paraquat poisoning. American Journal of the Medical Sciences 338(5): 373-377, 2009

Multiple logistic regression analysis of plasma paraquat concentrations as a predictor of outcome in 375 cases of paraquat poisoning. QJM 92(10): 573-578, 1999

Multiple logistic regression analysis of plasma paraquat concentrations as a predictor of outcome in 375 cases of paraquat poisoning. Qjm 92(10): 573-578, 2000

Prediction of outcome following paraquat poisoning by arterial lactate concentration-time data. Experimental and Therapeutic Medicine 8(2): 652-656, 2014

APACHE score, Severity Index of Paraquat Poisoning, and serum lactic acid concentration in the prognosis of paraquat poisoning of Chinese Patients. Pediatric Emergency Care 31(2): 117-121, 2016

Acute interstitial pulmonary fibrosis in a patient with paraquat poisoning clinical anatomical observation of a case of paraquat poisoning which had a fatal outcome. Muenchener Medizinische Wochenschrift6: 944-949, 1969

Analysis of prognostic value of initial serum paraquat concentration in patients with paraquat poisoning. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 33(9): 697-700, 2016

An autopsy case of paraquat poisoning--correlation of paraquat toxicity with tissue concentration. Nihon Kyobu Shikkan Gakkai Zasshi 23(5): 623-628, 1985

Serum paraquat concentration detected by spectrophotometry in patients with paraquat poisoning. World Journal of Emergency Medicine 2(3): 179-184, 2011

Peripheral burning sensation: a novel clinical marker of poor prognosis and higher plasma-paraquat concentrations in paraquat poisoning. Clinical Toxicology 48(4): 347-349, 2010

Paraquat poisoning: significance of plasma-paraquat concentrations. Lancet 2(8138): 330-332, 1979

Predictive values of urine paraquat concentration, dose of poison, arterial blood lactate and APACHE II score in the prognosis of patients with acute paraquat poisoning. Experimental and Therapeutic Medicine 14(1): 79-86, 2017

Clinical screening of paraquat in plasma samples using capillary electrophoresis with contactless conductivity detection: Towards rapid diagnosis and therapeutic treatment of acute paraquat poisoning in Vietnam. Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences 1060: 111-117, 2017