Lee J H, Kim Y W
1 Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
2 Department of Emergency Medicine, Inje University College of Medicine, Busan, Republic of Korea.
Hum Exp Toxicol. 2019 Jan;38(1):129-135. doi: 10.1177/0960327118783534. Epub 2018 Jul 4.
: Glufosinate-containing herbicide is increasingly used in agriculture. Its poisoning is a worldwide concern. More and more patients are poisoned by glufosinate. The aim of this study was to determine the factors associated with mortality of patients with acute poisoning of glufosinate.
: This was a retrospective cohort study conducted from January 1998 to October 2015. Using a multivariate logistic analysis, data for the total population were retrospectively analyzed to determine the factors associated with mortality. Various variables were compared in survivors and non-survivors. Significant predictive variables, Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system, the Simplified Acute Physiology Score (SAPS) II, and Sequential Organ Failure Assessment (SOFA) score were compared by analyzing receiver operating characteristic (ROC) curves.
: A total of 253 patients (mean age: 58 years) were enrolled. Of the 253 patients, 219 (86.6%) survived and 34 (13.4%) died. Decreased Glasgow Coma Scale (GCS) and bicarbonate (HCO), use of mechanical ventilator, and use of vasopressors (dopamine, dobutamine, norepinephrine) were associated with mortality. The areas under the curve in the ROC curve analysis for the predictive variables, SOFA score, APACHE II scoring system, and SAPS II were 0.952, 0.829, 0.927, and 0.944, respectively.
: Four predictive variables (GCS < 9, HCO < 16.0 mmol/L, mechanical ventilator apply, and use of vasopressors) were associated with mortality in the total population of patients with acute poisoning of glufosinate. These predictive variables had good discriminative power for predicting mortality of patients with acute poisoning of glufosinate-containing herbicide compared to APACHE II, SOFA, and SAPS II.
含草铵膦的除草剂在农业中的使用日益广泛。其中毒问题受到全球关注。越来越多的患者因草铵膦中毒。本研究旨在确定与急性草铵膦中毒患者死亡率相关的因素。
这是一项于1998年1月至2015年10月进行的回顾性队列研究。采用多因素逻辑分析，对总体人群的数据进行回顾性分析，以确定与死亡率相关的因素。对幸存者和非幸存者的各种变量进行了比较。通过分析受试者工作特征（ROC）曲线，比较了显著的预测变量、急性生理与慢性健康状况评估（APACHE）II评分系统、简化急性生理学评分（SAPS）II和序贯器官衰竭评估（SOFA）评分。
共纳入253例患者（平均年龄：58岁）。在这253例患者中，219例（86.6%）存活，34例（13.4%）死亡。格拉斯哥昏迷量表（GCS）和碳酸氢盐（HCO）降低、使用机械通气以及使用血管加压药（多巴胺、多巴酚丁胺、去甲肾上腺素）与死亡率相关。预测变量、SOFA评分、APACHE II评分系统和SAPS II在ROC曲线分析中的曲线下面积分别为0.952、0.829、0.927和0.944。
四个预测变量（GCS<9、HCO<16.0 mmol/L、使用机械通气和使用血管加压药）与急性草铵膦中毒患者总体人群的死亡率相关。与APACHE II、SOFA和SAPS II相比，这些预测变量在预测含草铵膦除草剂急性中毒患者死亡率方面具有良好的判别能力。
