ABSTRACT
Purpose@#Glyphosate herbicide (GH) is a widely used herbicide and has been associated with significant mortality as poisoned cases increases. One of the reasons for high toxicity is thought to be toxic effect of its ingredient with glyphosate. This study was designed to determine differences in the clinical course with the salt-type contained in GH. @*Methods@#This was a retrospective study conducted at a single hospital between January 2013 and December 2017. We enrolled GH-poisoned patients visited the emergency department. According to salt-type, patients were divided into 4 groups: isopropylamine (IPA), ammonium (Am), potassium (Po), and mixed salts (Mi) groups. The demographics, laboratory variables, complications, and their mortality were analyzed to determine clinical differences associated with each salt-type. Addtionally, we subdivided patients into survivor and non-survivor groups for investigating predictive factors for the mortality. @*Results@#Total of 348 GH-poisoned patients were divided as follows: IPA 248, Am 41, Po 10, and Mi 49 patients. There was no difference in demographic or underlying disease history, but systolic blood pressure (SBP) was low in Po group. The ratio of intentional ingestion was higher in Po and Mi groups. Metabolic acidosis and relatively high lactate level were presented in Po group.As the primary outcome, the mortality rates were as follows: IPA, 26 (10.5%); Am, 2 (4.9%); Po, 1 (10%); and Mi, 1 (2%). There was no statistically significant difference in the mortality and the incidence of complications. Additionally, age, low SBP, low pH, corrected QT (QTc) prolongation, and respiratory failure requiring mechanical ventilation were analyzed as independent predictors for mortality in a regression analysis. @*Conclusion@#There was no statistical difference in their complications and the mortality across the GH-salt groups in this study.
ABSTRACT
Objective@#Glufosinate-containing herbicide is being used increasingly in agriculture. Its poisoning is a worldwide concern. This study assessed the ability of the Poison Severity Score (PSS), Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring systems, and Sequential Organ Failure Assessment (SOFA) score to predict mortality in intensive care unit patients poisoned with glufosinate. @*Methods@#This was a retrospective cohort study conducted from January 2001 to January 2019. The demographic factors, hemodynamic variables, and laboratory variables were compared in survivors and non-survivors. Using multivariate logistic analysis, the data for the total population were analyzed retrospectively to determine the factors associated with mortality. Significant predictive variables, PSS, APACHE II scoring system, and SOFA score were compared by analyzing the receiver operating characteristic curves. @*Results@#Two hundred seventy-six patients (mean age, 56 years) were enrolled in this study. Of the 276 patients, 240 (87.0%) survived, and 36 (13.0%) died. The factors associated with mortality were a decreased mean arterial blood pressure, Glasgow Coma Scale, partial pressure of arterial oxygen/fraction of inspired oxygen, HCO3-, pH, and HCO3-, and an increased lactate, ammonia, C-reactive protein, PSS, SOFA score, and APACHE II score. Dyspnea, use of vasopressors, and application of mechanical ventilation were associated with mortality. In multivariate analysis, Glasgow Coma Scale5.2 mmol/L, use of vasopressors, and application of mechanical ventilation were predictive of mortality. The areas under the curve and 95% confidence intervals for these indicators were 0.920 (0.834-0.981), 0.865 (0.792-0.923), and 0.824 (0.752-0.897) for the PSS, APACHE II, and SOFA, respectively. @*Conclusion@#The PSS can be used to predict in-hospital mortality and stratify the risk among glufosinate-poisoned patients.
ABSTRACT
Objective@#Glufosinate-containing herbicide is being used increasingly in agriculture. Its poisoning is a worldwide concern. This study assessed the ability of the Poison Severity Score (PSS), Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring systems, and Sequential Organ Failure Assessment (SOFA) score to predict mortality in intensive care unit patients poisoned with glufosinate. @*Methods@#This was a retrospective cohort study conducted from January 2001 to January 2019. The demographic factors, hemodynamic variables, and laboratory variables were compared in survivors and non-survivors. Using multivariate logistic analysis, the data for the total population were analyzed retrospectively to determine the factors associated with mortality. Significant predictive variables, PSS, APACHE II scoring system, and SOFA score were compared by analyzing the receiver operating characteristic curves. @*Results@#Two hundred seventy-six patients (mean age, 56 years) were enrolled in this study. Of the 276 patients, 240 (87.0%) survived, and 36 (13.0%) died. The factors associated with mortality were a decreased mean arterial blood pressure, Glasgow Coma Scale, partial pressure of arterial oxygen/fraction of inspired oxygen, HCO3-, pH, and HCO3-, and an increased lactate, ammonia, C-reactive protein, PSS, SOFA score, and APACHE II score. Dyspnea, use of vasopressors, and application of mechanical ventilation were associated with mortality. In multivariate analysis, Glasgow Coma Scale5.2 mmol/L, use of vasopressors, and application of mechanical ventilation were predictive of mortality. The areas under the curve and 95% confidence intervals for these indicators were 0.920 (0.834-0.981), 0.865 (0.792-0.923), and 0.824 (0.752-0.897) for the PSS, APACHE II, and SOFA, respectively. @*Conclusion@#The PSS can be used to predict in-hospital mortality and stratify the risk among glufosinate-poisoned patients.