title: Prediction of patient survival in cases of acute paraquat poisoning.
abstract: Paraquat concentration-time data have been used to predict the clinical outcome following ingestion. However, these studies have included only small populations, although paraquat poisoning has a very high mortality rate. The purpose of this study was to develop a simple and reliable model to predict survival according to the time interval post-ingestion in patients with acute paraquat poisoning. Data were retrospectively collected for patients who were admitted with paraquat poisoning to Soonchunhyang University Choenan Hospital between January 2005 and December 2012. Plasma paraquat levels were measured using high-performance liquid chromatography. To validate the model we developed, we used external data from 788 subjects admitted to the Presbyterian Medical Center, Jeonju, Korea, between January 2007 and December 2012. Two thousand one hundred thirty six patients were included in this study. The overall survival rate was 44% (939/2136). The probability of survival for any specified time and concentration could be predicted as (exp(logit))/(1+exp(logit)), where logit = 1.3544+[-3.4688 × log10(plasma paraquat μg/M[Formula: see text])]+[-2.3169 × log10(hours since ingestion)]. The external validation study showed that our model was highly accurate for the prediction of survival (C statics 0.964; 95% CI [0.952-0.975]). We have developed a model that is effective for predicting survival after paraquat intoxication.
authors.affiliation: Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
authors.forename: Sae-Yong
authors.initials: SY
authors.lastname: Hong
authors.affiliation: Biostatistical Consulting Unit, Soonchunhyang University Medical Center, Seoul, Korea.
authors.forename: Ji-Sung
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea.
authors.forename: In O
authors.initials: IO
authors.lastname: Sun
authors.affiliation: Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea.
authors.forename: Kwang-Young
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
authors.forename: Hyo-Wook
authors.initials: HW
authors.lastname: Gil
mesh_terms: D000328:Adult; D000368:Aged; D002851:Chromatography, High Pressure Liquid; D006540:Herbicides / Q000097:blood / Q000506:poisoning*; D006801:Humans; D008875:Middle Aged; D010269:Paraquat / Q000097:blood / Q000506:poisoning*; D011041:Poisoning / Q000401:mortality; D016019:Survival Analysis
chemical_list: D006540:Herbicides; D010269:Paraquat