Predictive Value Of Poisoning Severity Score Combined With Troponin I In Arrhythmias Caused By Acute Aconitine Poisoning

Objective:To explore the predictive value of poison severity score(PSS)combined with cardiac troponin(cTnI)in arrhythmia induced by acute aconitine poisoning(AAP),which provide early prevention and treatment of arrhythmia induced by acute aconitine poisoning for evidence.Methods:We retrospectively analyzed the data of AAP patients who met the inclusion criteria in the emergency department of the Second Affiliated Hospital of Kunming Medical University from May 2013 to June 2019,and were divided into arrhythmia group and non-arrhythmia group according to whether arrhythmia occurred after admission Arrhythmia group.We collected the first PSS score and cTnI value of the two groups on admission,compared the difference between the first PSS score and cTnI value of the two groups on admission,and analyzed whether they were related to the occurrence of arrhythmia.Finally,we used the receiver operating characteristic curve(ROC)to detect the best cut-off value of PSS and cTnI,and compared the difference between the area under the curve(AUC)of PSS,cTnI and the combination of them.Results:The first:A total of 113 patients were included in our study,including 73 patients in the central arrhythmia group with an average age of 58.08±15.81 years;40 patients in the non-arrhythmic group with an average age of 54.58±14.13 years.There were no significant differences in gender,age,previous medical history(including hypertension,coronary heart disease,and other diseases)and the time from taking the drug to the consultation between the two groups(P>0.05).The second:The arrhythmia group PSS and cTnI were significantly higher than the non-arrhythmia group,the difference was statistically significant(P(0.01).The third:PSS,cTnI and arrhythmia were positively correlated(r=0.31,P=0.001;r=0.20,P=0.037).The fourth:The best cutoff values for PSS and cTnI are 1.5 points and 0.1ng/ml.The five:The area under the curve(AUC)of the arrhythmia group PSS,cTnI and the combined ROC were 0.67(95%CI:0.57-0.78),0.71(95%CI:0.62-0.81),and 0.76(95%CI:0.67-0.85),where the area under the ROC curve of the two is greater than PSS and cTnI,and the difference is statistically significant(P<0.05).Conclusions:First:The first PSS score and cTnI value are positively correlated with acute aconitine poisoning arrhythmia.The best cutoff values of PSS and cTnI are 1.5 points and 0.10ng/ml,which their sensitivity and specificity are 67%and 70%,55%and 90%,respectively.Second:AUC is the largest when PSS is combined with cTnI,and has the highest value for predicting the occurrence of arrhythmia in patients with acute aconitine poisoning.