Clinical Presentation, Laboratory Abnormalities, and Predictors of Outcome in 103 Patients With Acute Paraquat...

To study the clinical presentation and predictors of mortality in paraquat poisoning.

Prospective observational study.

Tertiary care teaching hospital.

Patients presenting with paraquat poisoning.

We studied the clinical presentation, laboratory abnormalities, and predictors of mortality in 103 consecutive patients admitted to the medicine wards and medical ICU with acute paraquat self-poisoning from August 2023 to March 2024.

The mean age of the patients was 29.5 ± 10.5 years, there were 73 males (70.8%). The most common presenting symptom was vomiting (93%) followed by throat pain (85%). Of the 103, 78 patients died (75.7%). On univariate analysis, significantly higher median (interquartile range) amount of poison consumed (45 mL [20-100 mL] vs. 10 mL [5-10 mL]; p < 0.001), serum creatinine (6 mg/dL [3.8-8.9 mg/dL] vs. 1.9 mg/dL [0.8-3.2 mg/dL]; p < 0.001), serum bilirubin (5.9 mg/dL [3.7-9.5 mg/dL] vs. 1.1 mg/dL [0.7-3.3 mg/dL]; p < 0.001), and Acute Physiology and Chronic Health Evaluation II score (15.5 [12-19] vs. 7 [3.5-11]; p < 0.001) and a significantly lower ratio of Pa o2 /F io2 at the time of admission (300 [150-400] vs. 420 [396-485]; p < 0.001) were evident in patients who died compared with survivors. An increasing trend in the mortality was observed with increasing International Program on Chemical Safety Poisoning Severity Score grade ( p = 0.001). On multivariable analysis, shortness of breath (odds ratio [OR], 0.008; p = 0.072), hepatic dysfunction (OR, 0.012; p = 0.048), duration of hospital stay (OR, 1.030; p = 0.023), and presence of infiltrates on chest radiograph/CT chest (OR, 0.003; p = 0.011) emerged as significant independent predictors of mortality.

Paraquat is a lethal poison associated with a high mortality. Identification of predictors of mortality can facilitate early aggressive attempts at initiating appropriate treatment.