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Risk factors and optimal predictive scoring system of mortality for children with acute paraquat poisoning

Yue Song1, Hua Wang1, Yu-Hong Tao1

  • 1Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.

World Journal of Clinical Cases
|July 8, 2022
PubMed

Insights

A new scoring system combining alanine aminotransferase (ALT) and pediatric critical illness score (PCIS) effectively predicts mortality in children with acute paraquat intoxication (APP). This tool aids in better risk assessment for APP patients.

Area of Science:

  • Pediatric Toxicology
  • Critical Care Medicine
  • Prognostic Biomarkers

Background:

  • Acute paraquat intoxication (APP) in children lacks a validated scoring system for mortality prediction.
  • Effective risk stratification is crucial for managing severe pediatric poisoning cases.

Purpose of the Study:

  • To optimize a predictive scoring system for mortality in pediatric patients with acute paraquat intoxication.
  • To identify independent prognostic risk factors for APP mortality in children.

Main Methods:

  • Retrospective analysis of 113 children with APP from 2010-2020.
  • Comparison of clinical characteristics between survivors and non-survivors.
  • Kaplan-Meier survival analysis and ROC curve analysis to establish the optimal scoring system.

Main Results:

  • Overall mortality rate was 23.4%, with most deaths occurring within 7 days.
  • Alanine aminotransferase (ALT) and pediatric critical illness score (PCIS) identified as independent prognostic risk factors.
  • Combined ALT and PCIS demonstrated high sensitivity (92.59%) and specificity (87.21%) for mortality prediction (AUC=0.937).

Conclusions:

  • ALT and PCIS are significant independent prognostic factors for pediatric APP mortality.
  • The combination of ALT and PCIS provides an optimal predictive scoring system for mortality in children with APP.
Abstract

Keywords:
Acute paraquat poisoningAlanine aminotransferaseChildrenPediatric critical illness scorePrognosis

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