The early prognostic factors of glyphosate-surfactant intoxication.
OBJECTIVE
The purpose of this study was to establish an early prognostic model of patients with glyphosate-surfactant (GlySH) herbicide intoxication.


METHODS
A case-control study was conducted. Data of GlySH-intoxicated patients were collected from 2 hospitals. Patients were admitted to the emergency departments (EDs) of Chang Gung Memorial Hospital from April 1996 to March 2003 and Taichung Veterans General Hospital from April 2000 to October 2003. Collected variables such as age, sex, estimated amount of ingestion, symptoms/signs including first vital signs, chest x-ray (CXR), and biochemical studies were analyzed for their role in the prognostic model of GlySH intoxication mortality. Univariate and odds ratio analyses were then performed. The prognostic model was then established by using logistic regression analysis and further stratified analysis.


RESULTS
Fifty-eight patients (19 men and 39 women; age, 48.8 +/- 15.8 years; P = .38) were enrolled in our study. Forty-one patients survived from GlySH intoxication and 17 died. After univariate analysis, 5 variables (respiratory distress needing intubation, metabolic acidosis, tachycardia, elevated creatinine (Cr) level, and hyperkalemia) were found to be highly associated with poor outcome and mortality. Then a multiple logistic regression model was established as follows: log(p/q) = -6.13 + 3.43 (abnormal CXR) + 2.53 (metabolic acidosis) + 2.55 (Cr) + 2.4 (tachycardia) + e.


CONCLUSIONS
GlySH poisoning is multiorgan toxicity. Pulmonary toxicity and renal toxicity seem to be responsible for its mortality. Metabolic acidosis, abnormal CXR, tachycardia, and elevated Cr level are useful prognostic factors for predicting GlySH mortality.
Lee
Ching-Hsing
CH
Department of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan Hsien, Taiwan 333. leech@adm.cgmh.org.tw
Shih
Chia-Pang
CP
Hsu
Kuang-Hung
KH
Hung
Dong-Zong
DZ
Lin
Chih-Chuan
CC
D016022:Case-Control Studies; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives* / Q000506:poisoning; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000401:mortality*; D011379:Prognosis; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D000097797:Glyphosate
D005998:Glycine; D006540:Herbicides; D000097797:Glyphosate