title: Abnormal pancreatic enzymes and their prognostic role after acute paraquat poisoning.
abstract: Ingestion of paraquat causes multi-organ failure. Prognosis is best estimated through measurement of blood paraquat concentrations but this facility is not available in most hospitals. We studied the prognostic significance of abnormal pancreatic enzymes for survival. Patients with acute paraquat poisoning were recruited. An extensive series of blood tests including serum amylase were serially checked. Patients were sorted according to their serum amylase activity (normal [<220 U/L], mildly elevated [220 to 660 U/L], elevated [>660 U/L]), and survival compared between groups. 177 patients were enrolled to the study, of whom 67 died and 110 survived. 122 (70.62%), 27 (15.25%) and 25 (14.13%) patients were in the normal, mildly elevated and elevated amylase activity groups, respectively. The case fatality in the elevated group was 100% compared to 17% in the normal group (P < 0.001). We found four independent factors for paraquat death prediction: amylase, PaCO2, leukocyte number, and neutrophil percentage. Models using pancreatic enzyme activity showed good prediction power. We have found that abnormal pancreatic enzymes are useful prognostic marker of death after acute paraquat poisoning. Including serum amylase activity into a prognostic model provides a good prognostication.
authors.affiliation: Emergency Department, Peking Union Medical College Hospital, Beijing 100730, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Science and Technology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Wang
authors.affiliation: Emergency Department, The First Affiliated hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Institute of Medical Information, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing 100020, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Pharmacology, Toxicology and Therapeutics, University of Edinburgh, Edinburgh, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Eddleston
authors.affiliation: Emergency Department, The First Affiliated hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Emergency Department, Peking Union Medical College Hospital, Beijing 100730, China.
authors.forename: Xuezhong
authors.initials: X
authors.lastname: Yu
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood / Q000378:metabolism; D019540:Area Under Curve; D002648:Child; D002675:Child, Preschool; D005260:Female; D006540:Herbicides / Q000506:poisoning* / Q000652:urine; D006801:Humans; D007223:Infant; D008049:Lipase / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology* / Q000401:mortality; D010179:Pancreas / Q000201:enzymology*; D010269:Paraquat / Q000506:poisoning* / Q000652:urine; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D006540:Herbicides; D008049:Lipase; D000681:Amylases; D010269:Paraquat