TO ASSESS THE CLINICAL PROFILE, TREATMENT, PROGNOSIS, AND OUTCOME OF ACUTE PARAQUAT POISONING AMONG PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL, BIMS BELAGAVI: A RETROSPECTIVE STUDY

Abstract

Introduction: Paraquat is a highly toxic bipyridyl herbicide associated with significant morbidity and mortality following acute poisoning, particularly in developing countries where its availability remains widespread. Owing to the absence of a specific antidote and the rapid progression to multiorgan dysfunction, outcomes in paraquat poisoning are often poor despite intensive supportive care. Identification of clinical and laboratory factors associated with mortality is essential for early risk stratification and management. This study was undertaken to evaluate demographic characteristics, organ dysfunction, treatment modalities, and their relationship with outcomes in patients presenting with acute paraquat poisoning.

Materials and methods: This is retrospective observational cross-sectional study conducted at a tertiary care centre, Civil Hospital BIMS, Belagavi. The study included patients aged ≥18 years with confirmed acute paraquat poisoning admitted during a one-year study period. This includes patients who were self-admitted or with witness account of paraquat exposure (ingestion, inhalational, mucosal or skin contact).

Results: Study population consisted of 40 males (76%) and 12 females (23%). Out of 52 patients 23 survived and 29 had fatal outcomes. Most patients belonged to 16-25 age group (38%) followed by 26-35 age group (23%). Hematological values were altered in 23 (55%) and normal in 29 (44%). Liver function test were altered in 20 (38%) and normal in 32 (61%). Age, gender and hemodialysis did not have any significant relation with mortality.. Hemodialysis had no relation with mortality but, 17.4% of patients who received hemodialysis survived.Majority of the patients had B/L clear lung fields 31(59.62%) followed by B/L lung opacities 9(17.31%), B/L ill defined opacities 8(15.38%) and B/L GGO 4(7.69%) respectively. Significant difference between mean values of survivors and non survivors of variables in (i)amount of paraquat consumed in ml p(0.047) (ii)derranged renal function p(0.018) (iii)age p(0.041) was noted and were significant.The mean+/-SD for survivors and non survivors was 36.74+/-44.46 and 45.34+/-38.73 respectively. The difference was statistically significant with p value 0.047.

Conclusion: There is no specifc antidote for paraquat poisoning. It is important to know the early diagnosis and prevent further absorption of poison from the gastrointestinal tract. The amount of paraquat poison consumed showed a statistically significant difference between survivors and non-survivors, supporting the dose-dependent nature of paraquat toxicity. Higher ingestion is associated with increased tissue accumulation and more severe organ dysfunction. Overall, mortality in paraquat poisoning is largely driven by the severity of systemic toxicity, particularly renal dysfunction.