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J Korean Soc Emerg Med > Volume 28(5); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(5): 467-474.
Prognosis of Acute Pancreatitis in Glyphosate Surfactant Herbicide-intoxicated Patients
Ingul Song, Seung Yong Cha, Mun Ju Kang, Yong Hwan Kim, Jun Ho Lee, Kwang Won Cho, Seong Youn Hwang, Dong Woo Lee
Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
Correspondence  Dong Woo Lee ,Tel: 055-233-6140, Fax: 055-233-6134, Email: calmriver@daum.net,
Received: June 19, 2017; Revised: June 20, 2017   Accepted: August 25, 2017.  Published online: October 31, 2017.
ABSTRACT
Purpose:
Glyphosate herbicides (GHs) are widely used and increasingly associated with poisoning cases. Acute pancreatitis (AP) is among the many complications associated with the toxicity of GHs. We investigated the relationship between incidence of AP and its prognosis in patients with GH poisoning.
Method:
This was a retrospective cohort study conducted at a single tertiary hospital between January 2004 and December 2014. We enrolled all patients presented to the emergency department with GH poisoning. The Clinical and laboratory variables were analyzed to investigate the relationship between GH intoxication and AP.
Results:
We studied 245 patients. Incidence of AP after GH poisoning was 6.5%. Patients with AP (mean 66 years) were older than the non-AP group (56 years). Systolic blood pressure, Glasgow Coma Scale, and amount of ingested poison differed significantly between the two groups. In the blood tests, white blood cell count, alanine aminotransferase, glucose, potassium, amylase, and lipase showed significant differences. The pH, bicarbonate, and lactate levels also differed significantly. Patients with AP demonstrated higher incidence of respiratory failure, pneumonia, acute kidney injury, rhabdomyolysis, and intensive care unit stay time. Additionally, 30-day mortality (n=11, 68.8%) was significantly higher in the AP group. On multivariate analysis, adjusted age, amount of ingestion, and lactate correlated with occurrence of AP.
Conclusion:
The incidence of GH-induced AP was 6.5% with a 30-day mortality of 68.8%. The patient’s age, ingested dosage, and lactate levels were associated with GH-induced AP.
Key words: Glyphosate, Pancreatitis, Poisoning, Lipase, Prognosis
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