Application of Sequential Organ Failure Assessment (SOFA) Score in the Prognostic Prediction of Paraquat Poisoning

Park,  Jung Geun; Jo,  Min Woo; Lim,  Hyun Sul

J Korean Soc Emerg Med > Volume 20(4); 2009 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2009;20(4): 385-391.

Application of Sequential Organ Failure Assessment (SOFA) Score in the Prognostic Prediction of Paraquat Poisoning

Jung Geun Park, Min Woo Jo, Hyun Sul Lim

¹Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. yohimbine@hanmail.net
²Department of Preventive Medicine, Ulsan University College of Medicine, Seoul, Korea.
³Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea.

ABSTRACT

PURPOSE:
To assess the ability of the Sequential Organ Failure Assessment (SOFA) score to predict the prognosis and organ dysfunction in the paraquat poisoning.
METHODS:
We retrospectively evaluated 281 paraquat poisoning patients who arrived at Soonchunhyang University Cheonan Hospital between Sep 2007 and Dec 2008. Sixty eight patients (68) were excluded due to missing data. Finally, 213 patents were included in this study. We investigated the degree of paraquat exposure, the Glasgow coma scale, vital signs, blood laboratory tests, calculated SOFA score, and Yamaguchi Index on first hospital day. The prognostic prediction was compared between SOFA score and Yamaguchi Index.
RESULTS:
The urine dithionite test, the amount of paraquat ingestion, arrival interval, aerum paraquat, Glasgow coma scale, HCO3-, potassium, and creatinine were significantly different between survivors and non-survivors. The Hosmer and Lemeshow Goodness-of-Fitness test of SOFA score (p=0.419) and Yamaguchi Index (p=0.084) indicated a good model performance. In the logistic regression analysis, p values the SOFA score and for the Yamaguchi Index were lower than 0.05 and the odds ratios were 1.930 and 0.108. At c-statistics, the area under receiver operator characteristic curve of SOFA score was 0.807 and Yamaguchi Index was 0.865. 95% confidence SOFA score and Yamaguchi Index Intervals of did not include 0.5.
CONCLUSION:
The SOFA score on the first day of hospital visit could reliably describe organ dysfunction and could distinguish survivors and non-survivors with reliable accuracy, as well as the Yamaguchi Index did in the case of paraquat poisoning.

Key words: Paraquat, Poisoning, Multiple organ failure, Progrosis