Analysis Of Risk Factors For Early Assessment Of Prognosis In Patients With Acute Paraquat Poisoning

Objective:Paraquat poisoning is common in clinical practice and has a high lethality.The purpose of this study was to investigate the risk factors for prognosis in patients with acute paraquat poisoning.Methods:The clinical data of patients with acute paraquat poisoning who were admitted to Emergency Department of Shengjing Hospital of China Medical University from January 2012 to June 2019 were retrospectively analyzed.The patients were distributed to the survival group and deat h group according to the outcome.The clinical data of the laboratory examination indexes of the two groups of patients at admission,at 24 h and changes in value within 24h of admission was analyzed.Logistic regression analysis and receiver operating characteristic curve（ROC curve）were used to study the change in value of blood test indicators to evaluate the prognosis of patients with acute paraquat poisoning.Results:The enrolled patients（n=251）with acute paraquat poisoning included the survival group（n=152）and death group（n=99）,with a mortality rate of 39.4%.The initial PaCO₂、WBC and NE were independent risk factors for patients with acute paraquat poisoning,with the AUC less than 0.7.The Pa CO₂ and Lac at 24h of admission were independent risk factors for patients with acute paraquat poisoning.The AUC of Pa CO₂ was 0.878,significantly more than Lac（AUC=0.659）,When Pa CO₂ was 26.5mmHg,the sensitivity was 76.9,the specificity was 92.0,and the diagnostic accuracy was 81.0%.^ΔLac、ΔsCr and^ΔK⁺within 24 hours of admission were independent risk factors for prognosis in patients with acute paraquat poisoning,and the AUC were 0.655,0.660 and 0.817,respectively.WhenΔLac was 1.85mmol/L,the sensitivity was 0.879,the specificity was 0.477,and the diagnostic accuracy was 70.2%.When^Δs Cr was 37.75μmol/L,the sensitivity was0.844,the specificity was 0.799,and the diagnostic accuracy was 80.5%.When^ΔK⁺was 0.42mmol/L,the sensitivity was 0.366,the specificity was 0.907,and the diagnostic accuracy was 68.3%.Conclusion:Lac and PaCO₂ at 24 hours of admission and^（35）Lac、（35）s Cr and^（35）K⁺within 24 hours of admission are independent risk factors for the prognosis of patients with acute paraquat poisoning,and it has good clinical application prospects.