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Pneumomediastinum predicts early mortality in acute paraquat poisoning

Chun-Yu Zhou1, Xin Kang, Chang-Bin Li

  • 1Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine , Shanghai , PR China.

Clinical Toxicology (Philadelphia, Pa.)
|June 16, 2015
PubMed
Abstract

Insights

Pneumomediastinum (PM) in paraquat (PQ) poisoning is a significant predictor of death. Early detection of PM within 8 days can help identify patients at higher risk for mortality.

Area of Science:

  • Toxicology
  • Clinical Medicine
  • Pulmonology

Background:

  • Paraquat (PQ) poisoning is a severe condition often leading to fatal outcomes.
  • Pneumomediastinum (PM) is a known complication, but its prognostic significance in PQ intoxication is not well-defined.

Purpose of the Study:

  • To investigate the clinical characteristics of pneumomediastinum (PM) in patients with paraquat (PQ) poisoning.
  • To determine the prognostic value of PM in predicting mortality following PQ intoxication.

Main Methods:

  • A cohort of 75 PQ-poisoned patients was studied, divided into groups with and without PM detected by chest CT.
  • Outcomes included 5- and 90-day mortality.
  • Survival analysis and Cox regression were used to identify risk factors.

Main Results:

  • PM was identified in 21.3% of patients, often appearing within 3 days of ingestion.
  • Patients with PM were younger and had higher severity scores (APACHE, SOFA), with increased incidence of acute renal failure, toxic hepatitis, and respiratory insufficiency.
  • PM was associated with significantly increased risks of both 5-day (HR 3.2) and 90-day (HR 2.4) mortality.

Conclusions:

  • Early pneumomediastinum (PM), developing within 8 days, is a specific and significant predictor of mortality in paraquat (PQ) poisoning.
  • Identifying PM aids in risk stratification and management of PQ-poisoned patients.
Keywords:
Computed tomographyMortalityParaquatPneumomediastinum

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