J Korean Soc Clin Toxicol.  2019 Jun;17(1):7-13. 10.22537/jksct.2019.17.1.7.

A Study of Predicting the Severity Following Glufosinate Ammonium Containing Herbicide Poisoning Experienced in Single Emergency Medical Institution

Affiliations
  • 1Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggido, Korea. ergogo@naver.com

Abstract

PURPOSE
Owing to the increased agricultural use of the herbicide glufosinate ammonium (GLA), the incidence of GLA poisoning has recently increased. Therefore, we investigated the possible predictive factors associated with severe complications following GLA poisoning.
METHODS
A retrospective analysis of medical records was conducted based on 76 patients who had visited our regional emergency medical center with GLA poisoning from 2006 to 2017. Severe complications were defined as respiratory failure requiring intubation, systolic blood pressure less than 90 mmHg, Glasgow Coma Scale (GCS) less than 8, and presence of seizure.
RESULTS
Age, ingested amount and ingested amount per weight were significantly greater in the severe group (p<0.001). PSS grade 2 or higher was more common in the severe group (p<0.001), and In addition, the APACHE II score was significantly higher in the severe group (p<0.001), as were the SOFA scores (p=0.002). Serum ammonia levels were significantly higher in the severe group (p=0.007), while MDRD-GFR was smaller in the severe group (p=0.002). The spot urine protein levels were significantly higher in the severe group (p=0.005), as was the urine protein to creatinine ratio (p=0.001). Upon multivariate analysis, the amount ingested per weight and PSS grade 2 or higher were identified as significant predictors.
CONCLUSION
Our study showed that MDRD-GFR was significantly lower in the severe group after GLA poisoning. PSS grade 2 or higher and ingested amount per weight may be useful to evaluate the severity of complications after GLA poisoning.

Keyword

Phosphinothricin; Poisoning; Complication

MeSH Terms

Ammonia
Ammonium Compounds*
APACHE
Blood Pressure
Creatinine
Emergencies*
Glasgow Coma Scale
Humans
Incidence
Intubation
Medical Records
Multivariate Analysis
Poisoning*
Respiratory Insufficiency
Retrospective Studies
Seizures
Ammonia
Creatinine
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