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首页> 外文期刊>Clinical toxicology: the official journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists >Pneumomediastinum predicts early mortality in acute paraquat poisoning
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Pneumomediastinum predicts early mortality in acute paraquat poisoning

机译：纵隔纵隔可预测百草枯中毒的早期死亡率

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Context. In paraquat (PQ) poisoning, death often occurs after the appearance of pneumomediastinum (PM). However, the clinical features and eventual outcome of PM in PQ intoxication remains unclear. Objective. We aimed to characterize PM following PQ poisoning and its prognostic value for predicting mortality. Materials and methods. Enrolled PQ-poisoned patients (n = 75) were divided into two groups according to whether PM could be detected by chest computed tomography or not. The study outcomes included 5- and 90-day death after intoxication. Survival curves were derived using the Kaplan-Meier method, and mortality risk factors were analyzed by forward stepwise Cox regression analysis. Results. PM was documented in 21.3% of the patients (16/75); in 13 of them PM set in within 3 days of PQ ingestion. 15 patients died within 3 days of appearance of PM. Compared with patients without PM, those with PM were younger (P = 0.011), and had higher scores of Acute Physiology and Chronic Health Evaluation (P < 0.001) and Sequential Organ Failure Assessment (P = 0.003). In addition, patients with PM had a higher incidence of acute renal failure (P = 0.001), toxic hepatitis (P = 0.008), and respiratory insufficiency (P = 0.003). PM predicted an increased risk of 90-day death (93.8% of patients with PM vs. 40.7% among those without PM; hazard ratio [HR], 2.4; 95% confidence interval [Cl], 1.0-5.6; P = 0.045), and increased risk of 5-day death (81.3% vs. 27.1%; HR, 3.2; 95% CI, 1.2-8.1; P = 0.017). Discussion and conclusion. Early PM, occurring within 8 days, is a specific predictor of mortality in PQ poisoning.
机译：上下文。在百草枯（PQ）中毒中，死亡通常发生在气肺纵隔（PM）出现之后。然而，PQ中毒的PM的临床特征和最终结果尚不清楚。目的。我们旨在表征PQ中毒后的PM及其对预测死亡率的预后价值。材料和方法。根据是否可以通过胸部计算机体层摄影术检测到PM，将入院的PQ中毒患者（n = 75）分为两组。研究结果包括中毒后5天和90天死亡。使用Kaplan-Meier方法得出生存曲线，并通过正向逐步Cox回归分析法分析死亡风险因素。结果。在21.3％的患者中记录了PM（16/75）;其中13例PM在摄入PQ后3天内设定。 PM出现后3天内有15名患者死亡。与没有PM的患者相比，患有PM的患者更年轻（P = 0.011），急性生理和慢性健康评估（P <0.001）和序贯器官衰竭评估（P = 0.003）得分更高。此外，PM患者的急性肾功能衰竭（P = 0.001），中毒性肝炎（P = 0.008）和呼吸功能不全（P = 0.003）的发生率更高。 PM预测90天死亡的风险增加（PM患者的93.8％相对于无PM患者中的40.7％;风险比[HR]为2.4; 95％置信区间[Cl]为1.0-5.6; P = 0.045） ，并增加了5天死亡的风险（81.3％比27.1％; HR为3.2; 95％CI为1.2-8.1; P = 0.017）。讨论和结论。发生在8天之内的早期PM是PQ中毒死亡率的特定预测指标。

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