Published online Feb 20, 2017. doi: 10.5493/wjem.v7.i1.31
Peer-review started: November 28, 2016
First decision: December 15, 2016
Revised: January 5, 2017
Accepted: January 16, 2017
Article in press: January 18, 2017
Published online: February 20, 2017
To evaluate various schemes for paraquat poisoning and different variables that influence the outcome of acute paraquat poisoning.
In a cross-sectional study, the information about all cases of acute paraquat poisoning who were admitted to teaching hospitals affiliated to Shiraz University of Medical Sciences, in a five year period (September 2010 to September 2015) were evaluated. The variables included: Demographic data, medical assessment, therapeutic options, laboratory findings, and the outcomes. Data were analyzed using SPSS, version 22. Significant difference between groups was tested using t-test for continues outcomes and χ2 test for categorical. The significance level was considered to be P < 0.05.
A total of 104 patients (66.3% male) were evaluated. The mean age of the female patients was 22.81 ± 9.87 years and the male patients’ was 27.21 ± 11.06 years. Ninety seven (93.3%) of all the cases were suicide attempts with mortality rate of 43.2%. Despite the necessity for emergency hemodialysis during the first 6 h of intoxication, none of the patients had dialysis during this time. Immunosuppressive and corticosteroid medications were not administrated in adequate dosage in 31.1% and 60% of the patients, respectively. Ingestion of more than 22.5 cc of paraquat and increase in creatinine level were the most important predictors of mortality.
Treatment should start immediately for these patients. Moreover, creating a clinical guideline according to the findings can have an impact on the treatment procedure which seems to be necessary.
Core tip: In developing countries with an agriculture economy poisoning by means of herbicides is very common. Paraquat is a highly toxic compound and consumption of 30 mg/kg is lethal in humans. In this study, we have analyzed multi-center data of patients with paraquat poisoning between September 2010 and September 2015, establishing the largest series of paraquat poisoning in the Middle East. Based on the data, medical knowhow that affects its current management as well as different variables which influence the outcome were evaluated.