The Anion Gap is a Predictive Clinical Marker for Death in Patients with Acute Pesticide Intoxication
Journal of Korean Medical Science
; : 1150-1159, 2016.
Article
en En
| WPRIM
| ID: wpr-13344
Biblioteca responsable:
WPRO
ABSTRACT
Pesticide formulation includes solvents (methanol and xylene) and antifreeze (ethylene glycol) whose metabolites are anions such as formic acid, hippuric acid, and oxalate. However, the effect of the anion gap on clinical outcome in acute pesticide intoxication requires clarification. In this prospective study, we compared the anion gap and other parameters between surviving versus deceased patients with acute pesticide intoxication. The following parameters were assessed in 1,058 patients with acute pesticide intoxication: blood chemistry (blood urea nitrogen, creatinine, glucose, lactic acid, liver enzymes, albumin, globulin, and urate), urinalysis (ketone bodies), arterial blood gas analysis, electrolytes (Na+, K+, Cl- HCO3 -, Ca++), pesticide field of use, class, and ingestion amount, clinical outcome (death rate, length of hospital stay, length of intensive care unit stay, and seriousness of toxic symptoms), and the calculated anion gap. Among the 481 patients with a high anion gap, 52.2% had a blood pH in the physiologic range, 35.8% had metabolic acidosis, and 12.1% had acidemia. Age, anion gap, pesticide field of use, pesticide class, seriousness of symptoms (all P < 0.001), and time lag after ingestion (P = 0.048) were significant risk factors for death in univariate analyses. Among these, age, anion gap, and pesticide class were significant risk factors for death in a multiple logistic regression analysis (P < 0.001). In conclusions, high anion gap is a significant risk factor for death, regardless of the accompanying acid-base balance status in patients with acute pesticide intoxication.
Palabras clave
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Plaguicidas
/
Equilibrio Ácido-Base
/
Acidosis
/
Análisis de los Gases de la Sangre
/
Biomarcadores
/
Modelos Logísticos
/
Oportunidad Relativa
/
Análisis de Supervivencia
/
Estudios Prospectivos
/
Factores de Riesgo
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Journal of Korean Medical Science
Año:
2016
Tipo del documento:
Article