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J Korean Soc Emerg Med > Volume 34(6); 2023 > Article
Journal of The Korean Society of Emergency Medicine 2023;34(6): 505-514.
글루포시네이트 암모늄 중독환자에서 신경학적 합병증 예측을 위한 지표
오정환1 , 한민정2 , 허준호1
1원광대학교병원 응급의학과
2전북대학교병원 소아청소년과
The prognostic factor for predicting neurologic sequalae in glufosinate ammonium intoxication
Jeong Hwan Oh1 , Min Jeong Han2 , Jun Ho Heo1
1Department of Emergency Medicine, Wonkwang University Hospital, Iksan, Korea
2Department of Pediatrics, Jeonbuk National University Hospital, Jeonju, Korea
Correspondence  Jun Ho Heo ,Tel: 063-859-1071, Fax: 063-859-2129, Email: tesaza22@hanmail.net,
Received: August 25, 2023; Revised: October 6, 2023   Accepted: November 2, 2023.  Published online: December 31, 2023.
ABSTRACT
Objective:
This study aimed to analyze the clinical characteristics of patients with acute glufosinate ammonium (GLA) poisoning and investigate the indicators associated with the severity of neurotoxicity in GLA-poisoned patients.
Method:
We retrospectively collected the data of patients who were admitted due to GLA poisoning from 2018 to 2022, to gather the factors that could influence neurologic outcomes. These outcomes were estimated based on the Glasgow Coma Scale (GCS) scores at admission, the worst GCS score during impaired consciousness, the GCS score at discharge, and the presence and duration of seizures.
Results:
Among the 67 GLA-poisoned patients, the average GCS score at admission was 13.8±2.6 points, the worst GCS score recorded was 11.2±3.5 points, and the GCS score at discharge was 13.7±2.9 points. The factors significantly influencing the GCS score at the initial admission included respiration rate, saturation, white blood cell count, and pH (P=0.037, P=0.005, P=0.021, and P=0.001, respectively). Factors affecting the worst GCS score included age, diastolic blood pressure, platelet count, blood urea nitrogen (BUN), and pH (P=0.001, P=0.016, P=0.015, P=0.002, and P<0.001, respectively). The GCS score at discharge exhibited significant correlations with age, BUN, and pH (P<0.001, P<0.001, and P=0.011, respectively). The average age of the patients who experienced seizures after GLA poisoning was significantly higher at 75.1±12.9 years compared to that of patients without seizures (mean age, 65.0±15.2 years; P=0.006). Additionally, the average bicarbonate level was lower in patients with seizures, measuring 19.0±4.7 mmol/L, when compared with that of patients without seizures (average, 21.4±4.3 mmol/L; P=0.045).
Conclusion:
The elderly, metabolic acidosis, and elevated BUN could serve as good indicators for adverse neurological outcomes in GLA-poisoned patients.
Key words: Glufosinate; Poisoning; Neurologic manifestations
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