The Value Of White Blood Cell Count And Arterial Blood Lactate Level In Prognosis Evaluation Of Patients With Acute Paraquat Poisoning

Objective:To analyze the relationship between early white blood cell count or arterial blood lactate and survival rate of patients with paraquat poisoning,estimating their prognostic value in these patients.Methods:The clinical data of 62 patients with acute paraquat poisoning who were admitted to Department of Emergency Medicine,Jinling Hospital,from Jan 2015 to Jan2018 retrospectively analyzed.Patients was divided into death or survival group based on their living status of the 28th days after poisoning.The white blood cell count,arterial blood lactate,other clinical laboratory tests and related data were statistically analyzed in the two groups.Logistic regression and ROC curves were used to evaluate the predictive value of white blood cell count,arterial blood lactate and the combination of the two indicators in the prognosis of patients with paraquat poisoning.Results:Sixty-two patients with acute paraquat poisoning were enrolled,35 died,27survived,and the mortality rate was 56%.The white blood cell count and arterial blood lactate in the death group were significantly higher than those in the survival group(P<0.05).Moreover,multivariate logistic regression showed white blood cell counts(regression coefficient=0.193,OR=1.213,95%CI:1.021,1.441,P<0.05),arterial blood lactate(regression coefficient=0.492,OR=1.635,95%CI:1.102,2.428,P<0.05)are independent risk factors in patients with paraquat poisoning.The area under(AUC)the ROC curve of white blood cell count was 0.874(95%CI:0.788,0.959),the maximum Youden index was 0.607,and the optimal cut-off value was 12.1×10~9/L.AUC of arterial blood lactate was 0.898(95%CI:0.835,0.985),the maximum Youden index was0.644,and the optimal cut-of-f value was 2.1mmol/L;AUC of combining the two is0.922(95%CI:0.851,0.993).With AUC>0.8 as the standard,the above parameters are effective indicators for evaluating the prognosis of death in patients with paraquat poisoning..Conclusion:Early white blood cell count and arterial blood lactate are independent risk factors associated with prognosis in patients with acute paraquat poisoning.The combination of the two parameters predicts the success rate of treatment in patients with acute paraquat poisoning well,which is expected to be used for clinical monitoring and prognosis evaluation of patients with paraquat poisoning.