The Predictive Value Of Early White Blood Cells Count Combined With Chest CT Scores In Acute Paraquat Poisoning

Objectives:The aim of this study is to identify the predictive value of the maximum white blood cells count(WBC)combined with the maximum chest CT scores in acute paraquat poisoning(APP),which is helpful for early diagnosis and treatment of APP patients.Methods:We performed a retrospectively analysis on data of APP patients who met the inclusion criteria in the emergency department of the Second Affiliated Hospital of Kunming Medical University from January 2014 to August 2020.The patients were divided into death group and survival group according to whether they died on the 28th day after poisoning.Difference of the maximum WBC and CT scores in two groups were compared.and the correlation between the peak of WBC,the peak of CT scores and the death of APP patients on the 28th day were analyzed.The best cut-off values of the maximum WBC value and CT scores within 1st to 3rd day were assessed using the receiver operating characteristic curve(ROC),and the diagnostic test accuracy of the peak of WBC,the peak of chest CT scores and their combination were compared using the area under the receiver-operating characteristics curve(AUC).Results:A total of 95 patients were enrolled.Among them,25 patients were included in the surviving group and 70 to the death group.There were no significant differences in gender,age,past medical history(including hypertension,diabetes,psychiatric disorders,and other diseases),pulse times,body temperature,systolic pressure,diastolic pressure,oxygen saturation between the two groups(p>0.05).There was also no difference in numbers of patients who were cured by blood purification between the two groups(p>0.05).The respiratory rate,glucose,toxic dosage and hospitalization time were significantly different in two groups(p<0.05).The peaks of WBC and chest CT scores in death group were significantly higher than those in survival group(p<0.001).And the maximum WBC and chest CT scores were linear correlation with prognosis of APP(r=0.444,p<0.001;r=0.333,p=0.001).The best cut-off value of the peaks of WBC and chest CT scores in APP prognosis were 14.63 X 109/L and 7 points,respectively.The AUCs of the peak of WBC,the peak of chest CT scores and their combination were 0.791(95%CI:0.702～0.880),0.717(95%CI:0.602～0.831)and 0.798(95%CI:0.700～0.897),respectively.And their combination has the biggest AUC.the differences of them were statistically significant(p<0.05).Conclusion(s):1.The maximum WBC and chest CT scores during 1st to 3rd day after poisoning were correlated with the prognosis of APP,respectively.The best cut-off values of them were 14.63 X 109/L and 7 points,respectively.2.The AUC of their combination has the largest value in three indicators.