Prognostic factors and prognostic value of acute organophosphorus pesticide poisoning / 预防医学

ABSTRACT

Objective To investigate theprognostic factors and prognostic value of acute organophosphorus pesticide poisoning. Methods Patients with acute organophosphorus pesticide from January 2009 to January 2017 in Cangzhou city emergency center from poisoning, describing the demographic characteristics, and clinical characteristics and prognosis of poisoning, using Logistic regression model analysis of admission when white blood cell count (WBC) , cholinesterase (ChE), lactic acid (Lac), blood glucose (GLU), serum myocardial enzymes (CK) and acute physiology and chronic health score (APACHE score) effects on the prognosis of patients, using Logistic regression probability prediction model and ROC curve analysis of the value of the index prediction on the prognosis of the patients. Results A total of 519 patients with acute organophosphorus pesticide poisoning were treated, the ratio of male to female was 1 :1.21 (235/284), the age was 20-50 years old (73.41%), mainly for farmers (64.74%), and the cause of poisoning was suicide (73.99%) . 87.09% patients were cured or improved, healed or dead patients accounted for 12.52%, accounting for 0.39% of the other. WBC (OR=5.056, 95% CI:1.714~14.915) , ChE (OR=5.190, 95% CI:1.396 ~ 19.298) , Lac (OR=5.124, 95% CI:1.347 ~ 19.497) , APACHE score (OR=10.098, 95% CI:1.311 ~ 77.767) is a risk factor for the prognosis of patients with organophosphorus poisoning. Logistic regression probability prediction results P=0.52, AUC:0.717 (95%CI:0.677~0.901), sensitivity: 0.70, specificity: 0.91, Kappa value: 0.460. The ROC curve was established by the APACHE II score alone, and the APACHE II score was 17.5 points, and AUC: 0.987 (95%CI:0.977~0.998), sensitivity: 0.99, specificity: 0.88, Kappa value: 0.543. Conclusion The scores of WBC, ChE, Lac and APACHE II were the prognostic factors of organophosphate poisoning. The predictive effect of the APACHE II score alone was better than that of WBC, ChE, Lac and APACHE II scoring.