Hyperamylasemia as an early predictor of mortality in patients with acute paraquat poisoning

• Published in: Journal of international medical research Vol. 48; no. 3; p. 300060520910037
• Main Authors: Huang, Changbao, Bai, Lina, Xue, Xiang, Peng, Liangfei, Jiang, Jinghan, Zhang, Xigang
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.03.2020; Sage Publications Ltd; SAGE Publishing
• Subjects: Acute Disease; Adult; Alanine Transaminase - blood; Amylases - blood; Area Under Curve; Creatinine - blood; Female; Hospitalization; Humans; Hyperamylasemia - blood; Hyperamylasemia - complications; Kaplan-Meier Estimate; Kinetics; Leukocyte Count; Male; Medical prognosis; Mortality; Multivariate Analysis; Oxidative stress; Paraquat - blood; Paraquat - poisoning; Poisoning; Proportional Hazards Models; Retrospective Clinical Research Report; ROC Curve; Survival analysis; Paraquat poisoning; mortality; prognostic factor; hyperamylasemia; pancreas; oxidative stress
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060520910037

Objective This study aimed to evaluate the relationship between elevated serum amylase levels and the prognosis of paraquat poisoning. Methods Patients were categorized into the elevated and non-elevated serum amylase groups according to serum amylase levels. Demographics, mortality, risk factors of elevated serum amylase levels, and injury to the pancreas were analyzed. Results A total of 457 patients were enrolled in this study and the overall mortality rate was 51.9%. Patients in the elevated group had worse indices than those in the non-elevated group. Kaplan–Meier survival analysis showed that the mortality rate in the elevated group was significantly higher than that in the non-elevated group (hazard ratio: 10.65, 95% confidence interval [CI]: 7.55–15.02). Multivariate Cox proportional hazards analysis showed that elevated serum amylase levels were related to mortality (hazard ratio: 2.066, 95% CI: 1.239–3.444). The receiver operating characteristic curve showed that the area under the curve was 0.724 (95% CI: 0.666–0.783) for serum amylase levels with 70.4% sensitivity and 74.0% specificity. Conclusion Elevated serum amylase levels are observed in PQ poisoning. This elevation might be one of the most accurate early prognostic factors for predicting severity and mortality.