Glufosinate 중독 환자의 신경학적 예후 인자로서 APACHE II Score의 유용성
Utility of the APACHE II Score as a Neurologic Prognostic Factor for Glufosinate Intoxicated Patients
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Purpose: The incidence of glufosinate poisoning is gradually increasing, and it can be fatal if severe poisoning occurs. However, factors useful for predicting the post-discharge neurological prognosis of patients who have ingested glufosinate have yet to be identified. Our objective was to evaluate the utility of the acute physiology and chronic health evaluation (APACHE) II score measured in the emergency department for predicting the neurological prognosis. Methods: From April 2012 to August 2014, we conducted a retrospective study of patients who had ingested glufosinate. The outcome of the patients at discharge was defined by the Cerebral Performance Category Score (CPC). The patients were divided into a good prognosis group (CPC 1, 2) and a poor prognosis group (CPC 3, 4, 5), after which the APACHE II scores were compared. The Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve from patients determined calibration and discrimination. Results: A total of 76 patients were enrolled (good prognosis group: 67 vs poor prognosis group: 9). The cut-off value for the APACHE II score was 12 and the area under the curve value was 0.891. The Hosmer and Lemeshow C statistic χ2 was 7.414 (p=0.387), indicating good calibration for APACHE II. Conclusion: The APACHE II score is useful at predicting the neurological prognosis of patients who have ingested glufosinate.
Abstract
Purpose: The incidence of glufosinate poisoning is gradually increasing, and it can be fatal if severe poisoning occurs. However, factors useful for predicting the post-discharge neurological prognosis of patients who have ingested glufosinate have yet to be identified. Our objective was to evaluate the utility of the acute physiology and chronic health evaluation (APACHE) II score measured in the emergency department for predicting the neurological prognosis. Methods: From April 2012 to August 2014, we conducted a retrospective study of patients who had ingested glufosinate. The outcome of the patients at discharge was defined by the Cerebral Performance Category Score (CPC). The patients were divided into a good prognosis group (CPC 1, 2) and a poor prognosis group (CPC 3, 4, 5), after which the APACHE II scores were compared. The Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve from patients determined calibration and discrimination. Results: A total of 76 patients were enrolled (good prognosis group: 67 vs poor prognosis group: 9). The cut-off value for the APACHE II score was 12 and the area under the curve value was 0.891. The Hosmer and Lemeshow C statistic χ2 was 7.414 (p=0.387), indicating good calibration for APACHE II. Conclusion: The APACHE II score is useful at predicting the neurological prognosis of patients who have ingested glufosinate.
참고문헌 (21)
- Lee SW, "Epidemiology and clinical analysis of poisoning of glufosinate herbicide -multicenter study-", J Korean Soc Clin Toxicol, 5, pp.36~42 (2007)
- 이정원, "Common Pesticides Used in Suicide Attempts Following the 2012 Paraquat Ban in Korea", Journal of Korean Medical Science, 30(10), pp.1517~1521 (2015), 대한의학회
- 황인우, "Glufosinate Ammonium (Bastaⓡ)중독의 임상적 특성 고찰", 대한응급의학회지, 15(2), pp.75~79 (2004), 대한응급의학회
- Tominack RL PSHIGL, "Goldflank’s Toxicologic Emergency", pp.1393~1410 (2002), McGrawHill
- Park KN, "APACHE III Score as a Prognostic Parameter in Acute Pancreatitis", Korean J Gastroenterol, 32, pp.508~515 (1998)
- Wagner DP, "Statistical validation of a severity of illness measure", Am J Public Health, 73, pp.878~884 (1983)
- Cummins RO, "Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. A statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council", Circulation, 84, pp.960~975 (1991)
- Diamond GA, "What price perfection? Calibration and discrimination of clinical prediction models", J Clin Epidemiol, 45, pp.85~89 (1992)
- Hanley JA, "The meaning and use of the area under a receiver operating characteristic (ROC) curve", Radiology, 143, pp.29~36 (1982)
- Hoerlein G, "Glufosinate (phosphinothricin), a natural amino acid with unexpected herbicidal properties", Rev Environ Contam Toxicol, 138, pp.73~145 (1994)
- Park HY, "Anterograde amnesia with hippocampal lesions following glufosinate intoxication", Neurology, 67, pp.914~915 (2006)
- Koyama K, "Delayed and severe toxicities of a herbicide containing glufosinate and a surfactant", Vet Hum Toxicol, 36, pp.17~18 (1994)
- Hori Y FM, "Drugs and Poisons in Humans: a Handbook of Practical Analysis", pp.545~557 (2005), Springer
- Lapouble E, "Phosphinothricin induces epileptic activity via nitric oxide production through NMDA receptor activation in adult mice", Brain Res, 957, pp.46~52 (2002)
- Matsumura N, "Glufosinate ammonium induces convulsion through Nmethyl-D-aspartate receptors in mice", Neurosci Lett, 304, pp.123~125 (2001)
- Nakaki T, "Glufosinate ammonium stimulates nitric oxide production through N-methyl D-aspartate receptors in rat cerebellum", Neurosci Lett, 290, pp.209~212 (2000)
- Watanabe T, "Neurological effects of glufosinate poisoning with a brief review", Hum Exp Toxicol, 17, pp.35~39 (1998)
- Mao YC, "Acute human glufosinate-containing herbicide poisoning", Clin Toxicol (Phila), 50, pp.396~402 (2012)
- Kang JH, "Clinical Considerations of Intoxication Caused by a Herbicide Containing Glufosinate Ammonium: 6 Cases Analysis", J Korean Soc Emerg Med, 9, pp.652~658 (1998)
- Inoue Y, "Factors associated with severe effects following acute glufosinate poisoning", Clin Toxicol (Phila), 51, pp.846~849 (2013)
- 구도현, "성인 뇌졸중 환자의 예후지표인자로서 Glasgow Coma Scale과 Simplified Motor Score의 비교 연구", 대한응급의학회지, 20(1), pp.95~100 (2009), 대한응급의학회