Department of Emergency Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China.
PLoS One. 2023 Feb 22;18(2):e0281897. doi: 10.1371/journal.pone.0281897. eCollection 2023.
Although the prognostic value of blood creatinine levels in patients with paraquat (PQ) poisoning has been studied for a long time, the results are still controversial. Therefore, we performed the first meta-analysis to comprehensively assess the value of blood creatinine in predicting the prognosis of patients with PQ poisoning. We searched PubMed, EMBase, Web of Science, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database, and China Online Journals to identify all relevant papers published up to June 2022. Data were extracted for pooled analysis, heterogeneity testing, sensitivity analysis, publication bias analysis, and subgroup analysis. Ultimately, 10 studies involving 862 patients were included. The I2 of diagnostic odds ratio (DOR), sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of this study were all greater than 50%, which showed the existence of heterogeneity in this study, and a random effects model was used for the combination of the above five effect sizes. Pooled analysis showed a high predictive value of blood creatinine for prognosis of PQ poisoning [pooled DOR:22.92, 95% confidence interval (CI):15.62-33.65, P < 0.001]. The combined sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 86% (95% CI: 0.79-0.91), 78% (95% CI: 0.69-0.86), 4.01 (95% CI: 2.81-5.71), and 0.17 (95% CI: 0.12-0.25), respectively. Deeks publication bias test revealed there was publication bias. Sensitivity analysis showed no significant differences in the estimates of impact. Serum creatinine is an effective predictor of mortality in patients with PQ poisoning.
虽然血液肌酐水平在百草枯（PQ）中毒患者中的预后价值已经研究了很长时间，但结果仍然存在争议。因此，我们进行了首次荟萃分析，以全面评估血液肌酐预测 PQ 中毒患者预后的价值。我们检索了 PubMed、EMBase、Web of Science、ScienceDirect、Cochrane Library、中国国家知识基础设施、中国科技期刊数据库和中国在线期刊，以确定截至 2022 年 6 月发表的所有相关文献。对纳入的研究进行数据提取和荟萃分析、异质性检验、敏感性分析、发表偏倚分析和亚组分析。最终纳入了 10 项研究，共 862 例患者。本研究诊断比值比（DOR）、敏感度、特异度、阳性似然比和阴性似然比的 I2 均大于 50%，表明本研究存在异质性，采用随机效应模型对上述五个效应量进行组合。荟萃分析显示，血液肌酐对 PQ 中毒预后具有较高的预测价值[汇总 DOR：22.92，95%置信区间（CI）：15.62-33.65，P < 0.001]。合并的敏感度、特异度、阳性似然比和阴性似然比分别为 86%（95%CI：0.79-0.91）、78%（95%CI：0.69-0.86）、4.01（95%CI：2.81-5.71）和 0.17（95%CI：0.12-0.25）。Deeks 发表偏倚检验显示存在发表偏倚。敏感性分析显示，影响的估计值无显著差异。血清肌酐是预测 PQ 中毒患者死亡率的有效指标。
