대한임상독성학회지 (Journal of The Korean Society of Clinical Toxicology)

  • 제21권2호
  • /
  • Pages.135-142
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  • 2023
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  • 1738-1320(pISSN)
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  • 2508-6332(eISSN)
대한임상독성학회 (Korean society of Clincal Toxicology)
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의식이 명료한 글루포시네이트 중독환자의 신경학적 예후인자로서 APACHE II의 유용성

Utility of the APACHE II score as a neurological prognostic factor for glufosinate-intoxicated patients with alert mental status

  • 이록 (순천향대학교 천안병원 응급의학과) ;
  • 신태용 (순천향대학교 천안병원 응급의학과) ;
  • 문형준 (순천향대학교 천안병원 응급의학과) ;
  • 이현정 (순천향대학교 천안병원 응급의학과) ;
  • 정동길 (순천향대학교 천안병원 응급의학과) ;
  • 이동욱 (순천향대학교 천안병원 응급의학과) ;
  • 홍선인 (순천향대학교 천안병원 감염내과) ;
  • 김현준 (순천향대학교 천안병원 응급의학과)
  • Rok Lee (Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Tae Yong Shin (Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Hyung Jun Moon (Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Hyun Jung Lee (Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Dongkil Jeong (Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Dongwook Lee (Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Sun In Hong (Division of Infectious Disease, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Hyun Joon Kim (Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital)
  • 투고 : 2023.10.14
  • 심사 : 2023.11.04
  • 발행 : 2023.12.31
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초록

Purpose: In patients with glufosinate poisoning, severe neurological symptoms may be closely related to a poor prognosis, but their appearance may be delayed. Therefore, this study aimed to determine whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) score could predict the neurological prognosis in patients with glufosinate poisoning who present to the emergency room with alert mental status. Methods: This study was conducted retrospectively through a chart review for patients over 18 years who presented to a single emergency medical center from January 2018 to December 2022 due to glufosinate poisoning. Patients were divided into groups with a good neurological prognosis (Cerebral Performance Category [CPC] Scale 1 or 2) and a poor prognosis (CPC Scale 3, 4, or 5) to identify whether any variables showed significant differences between the two groups. Results: There were 66 patients (67.3%) with good neurological prognoses and 32 (32.8%) with poor prognoses. In the multivariate logistic analysis, the APACHE II score, serum amylase, and co-ingestion of alcohol showed significant results, with odds ratios of 1.387 (95% confidence interval [CI], 1.027-1.844), 1.017 (95% CI, 1.002-1.032), and 0.196 (95% CI, 0.040-0.948), respectively. With an APACHE II score cutoff of 6.5, the AUC was 0.826 (95% CI, 0.746-0.912). The cutoff of serum amylase was 75.5 U/L, with an AUC was 0.761 (95% CI, 0.652-0.844), and the AUC of no co-ingestion with alcohol was 0.629 (95% CI, 0.527-0.722). Conclusion: The APACHE II score could be a useful indicator for predicting the neurological prognosis of patients with glufosinate poisoning who have alert mental status.

키워드

참고문헌

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