External validation of the prognostic index in acute paraquat poisoning

• Published in: Human & experimental toxicology 2016-04, Vol.35 (4), p.366-370
• Main Authors: Kim, DS, Kang, C, Kim, DH, Kim, SC, Lee, SH, Jeong, JH, Kang, TS, Jung, SM, Lee, SB, Lee, KW, Kim, RB
• Format: Article
• Language: English
• Subjects: Acute Disease; Confidence intervals; Creatinine; Health risk assessment; Hospital Mortality; Humans; Ingestion; Mortality; Paraquat; Paraquat - poisoning; Patients; Poisoning; Prognosis; Reproducibility of Results; Retrospective Studies; Severity of Illness Index; Time Factors
• ISSN: 0960-3271; 1477-0903
• DOI: 10.1177/0960327115586821

Objective: Some studies have evaluated the prognostic indicators associated with acute paraquat (PQ) poisoning. In this study, we externally validated the Yamaguchi index, which showed a good prognostic relevance in predicting the outcome of PQ poisoning. Methods: A retrospective analysis of 297 patients was performed. The Yamaguchi index was calculated using the following equation: Eq1 = (K+ × HCO3−)/(Creatinine × 0.088)(mEq/L) against time from PQ ingestion (T). The patients were divided into three groups: group A: Eq1 > 1500 − 399 × log T, group B: 930 − 399 × log T < Eq1 ≤ 1500 − 399 × log T, and group C: Eq1 ≤ 930 − 399 × log T). Results: The overall mortality rate was 65.3% (194 of 297). The mortality rates of the three groups stratified by the Yamaguchi index were 7.1% (2 of 28), 22.4% (15 of 67), and 87.6% (177 of 202). The area under the receiver–operating characteristic curve for predicting mortality from the external validation of the Yamaguchi index was 0.842 (95% confidence interval: 0.795–0.882). Conclusion: The Yamaguchi index is a reliable prognostic factor and could be helpful in predicting mortality due to PQ poisoning.