抄録
Purpose: Glufosinate poisoning can cause complications that may be difficult to treat due to their delayed manifestation. Studies assessing possible predictors of complications are lacking. Although serum ammonia level is a probable predictor of severe neurotoxicity, it has only been assessed via case reports. Therefore, we investigated factors that predict complications in acute glufosinate-poisoned patients.
Materials and Methods: We conducted a retrospective review of 45 consecutive glufosinate poisoning cases that were diagnosed and treated in the emergency department of Wonju Severance Christian Hospital between May 2007 and July 2014. The patients were divided into a severe group, defined as patients with Glasgow Coma Scale (GCS)<8, seizure, amnesia, respiratory failure, shock, pneumonia, acute kidney injury, and death, while the non-severe group included patients with none of these complications.
Results: The severe group included 29 patients (64.4%). The complications were GCS<8 (27 patients, 60.0%), seizure (23 patients, 51.1%), respiratory failure (14 patients, 31.1%), shock (2 patients, 4.4%), pneumonia (16 patients, 35.6%), acute kidney injury (10 patients, 22.2%), and death (4 patients, 8.9%), respectively. Initial serum ammonia was a predictor of complications [odds ratio 1.039, 95% confidence interval (1.001-1.078), p=0.046]. The optimal point for initial serum ammonia was 86 ug/dL [sensitivity: 72%, specificity: 64%, and area under the curve 0.742].
Conclusion: Complications developed in 64.4% of patients with acute glufosinate poisoning. The most common complication was GCS<8. Initial serum ammonia level>86 ug/dL could be a predictor of complications that can be readily assessed in the ED for acute glufosinate-poisoned patients.
