Clinical Profile, Organ Dysfunction Patterns, and Outcomes in Paraquat Poisoning: A Retrospective Analysis

Area of Science:

• Toxicology
• Clinical Medicine
• Public Health

Background:

• Paraquat is a highly toxic herbicide with high mortality rates after ingestion.
• Its availability in rural agricultural regions of India contributes to poisoning incidents.

Purpose of the Study:

• To characterize clinical profiles and organ dysfunction in acute paraquat poisoning.
• To correlate organ dysfunction patterns with in-hospital mortality in a rural tertiary care setting.

Main Methods:

• Retrospective observational study of adult patients with acute oral paraquat ingestion.
• Analysis of demographic data, clinical features, organ involvement, treatments, and outcomes.
• Study conducted in a South Indian tertiary care hospital from August 2020 to August 2025.

Main Results:

• Twenty-seven patients (mean age 33.4 years, 74.1% male) were included; all ingestions were intentional.
• Multiorgan involvement was frequent: respiratory failure (92.6%), acute kidney injury (77.8%), circulatory failure (74.1%), hepatic dysfunction (33.3%).
• Overall in-hospital mortality was 74.1% (20/27), increasing with organ dysfunction: 0% for single-organ, 50% for two-organ, and 100% for three or more organ systems.

Conclusions:

• Acute paraquat poisoning leads to severe multisystem toxicity and high mortality.
• Mortality is strongly associated with the number of dysfunctional organ systems, uniformly fatal with three or more.
• Enhanced institutional preparedness and regulatory measures are needed where paraquat is accessible.