title: The time between paraquat ingestion and a negative dithionite urine test in an independent risk factor for death and organ failure in acute paraquat intoxication.
abstract: To identify a prognostic marker that is less sensitive to variations in the elapsed time since paraquat ingestion, we assessed the time between paraquat ingestion and a negative dithionite urine test as a prognostic parameter in patients with acute paraquat intoxication. Forty-one patients with acute paraquat intoxication were enrolled in this study and analyzed to verify significant determinants of mortality and organ dysfunction. The amount of paraquat ingested, paraquat plasma levels, and the time to a negative urine dithionite test were significant independent risk factors predicting mortality. The amount of paraquat ingestion, and the time to a negative urine dithionite test were independent risk factors predicting organ dysfunction. With a cut-off value of 34.5 hr for the time to negative conversion of the urine dithionite test, the sensitivity and specificity for mortality were 71.4% and 75.0%, respectively. The incidence of acute kidney injury and respiratory failure above 34.5 hr were 100% and 85.0%, respectively. In conclusion, the time to a negative urine dithionite test is the reliable marker for predicting mortality and/or essential organ failure in patients with acute paraquat intoxication, who survive 72 hr.
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
authors.forename: Sujin
authors.initials: S
authors.lastname: Seok
authors.forename: Young-hee
authors.initials: YH
authors.lastname: Kim
authors.forename: Hyo-wook
authors.initials: HW
authors.lastname: Gil
authors.forename: Ho-yeon
authors.initials: HY
authors.lastname: Song
authors.forename: Sae-yong
authors.initials: SY
authors.lastname: Hong
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality; D000328:Adult; D000368:Aged; D004227:Dithionite / Q000652:urine*; D005260:Female; D006540:Herbicides / Q000097:blood / Q000633:toxicity*; D006801:Humans; D008107:Liver Diseases / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010269:Paraquat / Q000097:blood / Q000633:toxicity*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D013997:Time Factors
chemical_list: D006540:Herbicides; D004227:Dithionite; D010269:Paraquat