Predicting Death in Paraquat Poisoning with Biomarkers
Author Information
Author(s): Darren M. Roberts, Martin F. Wilks, Michael S. Roberts, Ramasamy Swaminathan, Mohamed Fahim, Andrew H. Dawson, Nick A. Buckley
Primary Institution: South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
Hypothesis
The study aims to validate the predictive value of serial creatinine concentrations and to assess the utility of cystatin C and NGAL as predictors of outcome in patients with acute paraquat poisoning.
Conclusion
The rate of increase in creatinine and cystatin C concentrations may be useful for predicting outcomes in patients with acute paraquat poisoning.
Supporting Evidence
- An increase in creatinine >3 μmol/L/h predicts death in paraquat poisoning.
- The dCr/dt ROC curve had an area of 0.93, indicating strong predictive ability.
- Cystatin C also showed a significant increase in patients who died.
Takeaway
Doctors can check certain blood markers to see if someone who drank paraquat might get very sick or die.
Methodology
Patients with acute paraquat exposure were prospectively identified and followed for changes in blood biomarkers.
Potential Biases
Patients may have declined participation due to the grim prognosis associated with paraquat poisoning.
Limitations
The study had a small sample size and relied on patient consent for blood sample collection.
Participant Demographics
Patients were from Sri Lanka, with a history of acute paraquat exposure.
Statistical Information
P-Value
0.002
Confidence Interval
95% CI 0.83–1.04 for dCr/dt; 95% CI 0.90–1.04 for dCyC/dt
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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