Multiple logistic regression analysis of plasma paraquat concentrations asa predictor of outcome in 375 cases of paraquat poisoning

Successful prediction of who may survive paraquat poisoning can prevent ina ppropriately aggressive treatment in those who have little hope of survival and those only minimally poisoned. We examined case records of patients ad mitted to one poisoning treatment unit over the last 5 years, and the Engli sh and French language literature on paraquat poisoning. Data were recorded from all patients where outcome and timed plasma paraquat concentrations w ere present. Of 375 patients (113 M, 62 F, 200 unknown), mean age 38.3 year s (range 1-87 years), 49 had evidence of renal toxicity, and 41 received ha emodialysis or charcoal haemoperfusion; 61 developed pulmonary sequelae; an d 44 had lesions in the upper gastrointestinal tract.; Median time from ing estion to death in the 241 deaths reported was 270 h (range 3-720 h). We pl otted log(plasma paraquat concentration) against log(h since ingestion). Th e predicted probability of survival for any specified time and concentratio n was exp(logit)/[1 + exp(logit)], where logit= 0.58-2.33 x log(plasma para quat)-1.15 x log(h since ingestion). This equation may be helpful in predic ting who will survive after ingestion of paraquat up to at least 200 h afte r ingestion, and can now be used as a research tool for studies on efficacy of treatment of paraquat poisoning.