Establishment of a 30-day prognostic model of paraquat or diquat poisoning patients
Objective To explore the factors for 30-day prognosis of patients with paraquat(PQ)or diquat(DQ)poisoning so as to establish a binary Logistic equation to judge the prognosis and provide effective treatment.Methods We recruited 109 patients with PQ(n=82)or DQ(n=27)poisoning who met the inclusion and exclusion criteria in The First and The Second Affiliated Hospital of Xi'an Jiaotong University from January 2010 to October 2021,and obtained their prognosis of 30 days by medical records and telephone.The death group(n=46)and the survival group(n=63)were divided.The clinical data,biochemical data at 1 h after admission,administration of hemoperfusion(HP)and whether HP combined with continuous renal replacement treatment(CRRT)were compared between the two groups.The independent risk factors in the two groups were analyzed,and the binary Logistic regression equation model was established and verified.Results Age,dosage,lactic acid(Lac),and administration of HP were independent risk factors for 30 days mortality(P<0.05).Regression equation:Y=Logit(P)=-3.588+0.05 × age+0.031 × dosage+0.467 × Lac-1.915 × presence of HP(no HP assigned as 0,with HP assigned as 1).The model was tested by Hosmer-Lemeshow goodness of fit:x2=7.645,freedom=8,P=0.469,which indicated that the model had a good fit.The sensitivity of the model was 86.96%,the specificity was 88.89%,area under the curve(AUC)was 0.93,the 95%confidence interval(CI)was 0.88-0.98,and the P value was<0.001.The calibration degree of the model was good,and the C-index was 0.931.The clinical decision curve analysis(DCA)showed that the model had a good standardized net benefit.Conclusion The model can scientifically and effectively predict the 30-day prognosis of patients with PQ or DQ poisoning and guide clinicians.