Frontiers in medicine · 2026
Clinical characteristics and early admission predictors of in-hospital death in acute paraquat poisoning: a retrospective cohort study of 128 patients.
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Chen Yuquan, Xie Meiwen, Ye Yifan, Lin Yuqiang, Yang Zhiqian, Wang Zhi
Аннотация
BACKGROUND: Acute paraquat (PQ) poisoning is associated with high mortality and rapid multi-organ injury. Early risk stratification is particularly important when plasma or urine PQ concentrations are unavailable. This study aimed to characterize acute PQ poisoning and identify routinely available admission variables associated with in-hospital death.
METHODS: We retrospectively enrolled 128 consecutive patients with acute PQ poisoning admitted to Guangzhou Twelfth People's Hospital between January 2008 and December 2020. Patients were categorized as survivors (n = 46) or non-survivors (n = 82) according to in-hospital outcome. Continuous variables were analyzed using the Mann-Whitney U test and categorical variables using the chi-square test or Fisher's exact test, as appropriate. Clinically relevant admission variables were screened for collinearity and entered into a backward stepwise binary logistic regression model in SPSS 25.0. ROC curves were generated in R, and AUCs with 95% confidence intervals were calculated.
RESULTS: The in-hospital mortality rate was 64.06%. Compared with survivors, non-survivors had significantly higher ingested dose, coagulation indices, inflammatory markers, liver injury markers, renal function indices, and myocardial injury markers (all p < 0.05). In multivariable analysis, ingested dose (OR = 1.016, 95% CI: 1.003-1.029, p = 0.015) and AST (OR = 1.027, 95% CI: 1.011-1.042, p = 0.001) were independently associated with in-hospital death. AST showed the best discrimination among single markers (AUC = 0.911, 95% CI: 0.855-0.958).
CONCLUSION: Ingested dose and AST were independently associated with in-hospital death in acute PQ poisoning, and AST showed the best single-marker discriminative performance.
METHODS: We retrospectively enrolled 128 consecutive patients with acute PQ poisoning admitted to Guangzhou Twelfth People's Hospital between January 2008 and December 2020. Patients were categorized as survivors (n = 46) or non-survivors (n = 82) according to in-hospital outcome. Continuous variables were analyzed using the Mann-Whitney U test and categorical variables using the chi-square test or Fisher's exact test, as appropriate. Clinically relevant admission variables were screened for collinearity and entered into a backward stepwise binary logistic regression model in SPSS 25.0. ROC curves were generated in R, and AUCs with 95% confidence intervals were calculated.
RESULTS: The in-hospital mortality rate was 64.06%. Compared with survivors, non-survivors had significantly higher ingested dose, coagulation indices, inflammatory markers, liver injury markers, renal function indices, and myocardial injury markers (all p < 0.05). In multivariable analysis, ingested dose (OR = 1.016, 95% CI: 1.003-1.029, p = 0.015) and AST (OR = 1.027, 95% CI: 1.011-1.042, p = 0.001) were independently associated with in-hospital death. AST showed the best discrimination among single markers (AUC = 0.911, 95% CI: 0.855-0.958).
CONCLUSION: Ingested dose and AST were independently associated with in-hospital death in acute PQ poisoning, and AST showed the best single-marker discriminative performance.