Original ContributionThe early prognostic factors of glyphosate-surfactant intoxication
Introduction
Glyphosate-surfactant (GlySH) is one of the commonly used herbicides and GlySH poisoning had been reported [1], [2], [3], [4], [5]. The toxic syndrome of GlySH was proposed as gastrointestinal irritation, dysfunction of hepatorenal system, and more severe, pulmonary toxicity and cardiovascular system instability [1], [2], [3], [4], [5]. The cause of death after GlySH poisoning remains a controversial issue. Some authors believed it is due to pulmonary toxicity, such as pulmonary edema and/or aspiration pneumonitis, whereas others think cardiogenic and/or hypotensive shock is the cause of death [1], [2], [5], [6], [7]. A prognostic model not only plays a critical role in assessing the severity of poisoning in GlySH-intoxicated patients, but also helps in the management of such kinds of patients. Furthermore, the assay of the prognostic factors may give us a clue as to the cause of death of GlySH-intoxicated patients. At present, one prognostic model has been proposed. However, it is an unstable one [5]. Other authors reported some prognostic factors but they were not early predictors [6], [8]. The purpose of this study was to establish an early prognostic model of GlySH-intoxicated patients.
Section snippets
Methods
This was a case-control study of GlySH-intoxicated patients. Patients were admitted to the emergency departments (EDs) of Chang Gung Memorial Hospital from April 1996 to March 2003 and Taichung Veterans General Hospital from April 2000 to October 2003. Taichung Veterans General Hospital is a medical center serving the middle area of Taiwan. A poison control center is located inside the hospital. Chang Gung Memorial Hospital is a medical center and referral center serving the north area of
Results
Fifty-eight patients (19 men and 39 women, P = .38) were enrolled in our study. As shown in Table 1, Table 2, the patients' age was 48.8 ± 15.8 years. Forty-one patients survived GlySH intoxication and 17 died. The most common intoxication reason was attempted suicide (50/58, 86.2%). The most common symptoms were nausea/vomiting (28/58, 48.3%), oral pain (17/58, 29.3%), and abdominal pain (10/58, 17.2%). Fifteen patients (15/58, 25.9%) drank ethanol alcohol at the same time as well. The
Discussion
The main purpose of this study was to test the association between abnormal CXR and GlySH poisoning survivorship. According to Breslow and Day [10], the odds ratio of death between abnormal and normal CXR is P1(1 − P2)/P2(1 − P1) = 0.824(1 − 0.244)/0.244(1 − 0.824) = 14.5, where P1 refers to the proportion of abnormal CXR in the deceased group and P2 refers to the proportion of abnormal CXR in the survival group. Therefore, the sample size (n) of 58 (17 deceased and 41 survivors) reached
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2016, Toxicology LettersCitation Excerpt :GPSH mediated toxicity may also be due to lipid peroxidation (Mensah et al., 2012), oxidative stress (Guilherme et al., 2012) and DNA damage (Navarro and Martinez, 2014). Although most patients remain asymptomatic following mild poisoning (Bradberry et al., 2004; Chen et al., 2009; Roberts et al., 2010), acute kidney injury (AKI) is a salient clinical feature of moderate to severe poisoning (Bradberry et al., 2004; Lee et al., 2008; Moon and Chun, 2010; Moon et al., 2006; Nelsen et al., 2009; Roberts et al., 2010; Seok et al., 2011) and an important predictor of poor outcome (Bradberry et al., 2004; Lee and Guo, 2011; Lee et al., 2000; Moon and Chun, 2010). AKI is diagnosed using conventional markers of renal function (creatinine and urine output), and these have been incorporated into most widely used definitions of AKI despite their limitations (KDIGO, 2012; Mehta et al., 2007).