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J Korean Soc Emerg Med > Volume 20(6); 2009 > Article
Journal of The Korean Society of Emergency Medicine 2009;20(6): 666-672.
Predictive Factors for Early Hospital Discharge in Glyphosate Surfactant Herbicidal Poisonings
Mee Ran Song, Young Ho Jin, Jae Chol Yoon, Tae Oh Jeong, Jae Baek Lee
Department of Emergency Medicine, Medical School, Chonbuk National University, Jeonju, Korea. emjin@chonbuk.ac.kr
Glyphosate-surfactant herbicide (GSH) is a widely used herbicide that is generally thought to be safe. When ingested in large quantities, however, it can result in serious toxicity and even lethality. The purpose of this study was to identify predictive factors for early hospital discharge in GSH poisonings.
GSH poisoning patients were divided into two groups. Group A consisted of patients who were discharged earlier, within 48 hours, without any complication since ED admission. Group B included patients who were admitted to the ED more than 48 hours earlier and/or who died within 48 hours of ED admission. Patient demographics, drug intoxication information, chest X-ray (CXR) findings and laboratory data during the first 24 hours on ED admission were collected. Those data were analyzed for their effect on the two groups. Univariate and odds ratio analysis were done. Predictive factors for early hospital discharge were then determined using logistic regression analysis.
Seventy three patients (51 males, 22 females) were enrolled in our study; 39 patients in group A, and 34 patients in group B. By univariate and odds ratio analysis, the following variables showed statistically significant differences between groups A and B: estimated amount of poison ingested?, GSC score, CXR findings, arterial pH, PO2, bicarbonate, BUN, creatinine, amylase and potassium. In the analysis of clinical symptoms and signs, mental change, dyspnea and voice change were the significant findings in group B (p<0.05). In multivariate logistic regression analysis to predict early discharge in GSH poisonings, 3 variables (normal CXR finding, no metabolic acidosis, BUN level < or = 23) were found to be highly associated with early discharge. We established the following multiple logistic regression model: Log(p/1-p) = -3.02+1.85(normal CXR)+1.98(no metabolic acidosis)+1.46(BUN< or =23)
Although GSH poisoning causes multi-organ toxicity, its mortality rate is relatively low (5.5%). Acid-base status, chest X-ray finding, and serum BUN level during the first 24 hours are useful predictive factors for early discharge from the hospital in GSH poisonings.
Key words: Poisoning, Herbicides, Glyphosate
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