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©The Author(s) 2022.
World J Clin Cases. May 26, 2022; 10(15): 4799-4809
Published online May 26, 2022. doi: 10.12998/wjcc.v10.i15.4799
Published online May 26, 2022. doi: 10.12998/wjcc.v10.i15.4799
Table 1 Pediatric critical illness score
Parameter | Age < 1 yr | Age ≥ 1 yr | Scores |
Heart rate (beats/min) | < 80 or > 180 | < 60 or > 160 | 4 |
80-100 or 160-180 | 60-80 or 140-160 | 6 | |
Others | Others | 10 | |
Blood pressure (systolic) [kPa (mmHg)] | < 7.5 (55) or > 17.3 (130) | < 8.7 (65) or > 20 (150) | 4 |
7.5-8.7 (55-65) or 13.3-17.3 (100-130) | 8.7-10 (65-75) or 17.3-20 (130-150) | 6 | |
Others | Others | 10 | |
Breathing rate (breaths/min) | < 20 or > 70 or irregular breathing | < 15 or > 60 or irregular breathing | 4 |
20-25 or 40-70 | 15-20 or 35-60 | 6 | |
Others | Others | 10 | |
PaO2 [kPa (mmHg)] (no oxygen inhalation) | < 6.7 (50) | 4 | |
6.7-9.3 (50-70) | 6 | ||
Others | 10 | ||
pH | < 7.25 or > 7.55 | 4 | |
7.25-7.30 or 7.50-7.55 | 6 | ||
Others | 10 | ||
Na+ (mmol/L) | < 120 or > 160 | 4 | |
120-130 or 150-160 | 6 | ||
Others | 10 | ||
K + (mmol/L) | < 3.0 or > 6.5 | 4 | |
3.0-3.5 or 5.5-6.5 | 6 | ||
Others | 10 | ||
Scr (μmol/L) | > 159 | 4 | |
106-159 | 6 | ||
Others | 10 | ||
BUN (mmol/L) | > 14.3 | 4 | |
7.1-14.3 | 6 | ||
Others | 10 | ||
Hb (g/L) | < 60 | 4 | |
60-90 | 6 | ||
Others | 10 | ||
Digestive system symptoms | Stress ulcer bleeding and intestinal paralysis | 4 | |
Stress ulcer bleeding | 6 | ||
Others | 10 |
Table 2 The pediatric early warning score
0 | 1 | 2 | 3 | |
Behavior | Playing; alert; appropriate; at baseline | Sleeping; fussy but consolable | Irritable/inconsolable | Lethargic; confused; reduced response to pain |
Cardiovascular status | Pink cap refill 1-2 s | Gray; cap refill 3 s | Gray; cap refill 4 s; tachycardia of 20 beats/min above the normal rate | Gray; mottled; cap refill 5 s; tachycardia of 30 beats/min above the normal rate; bradycardia |
Respiratory status | Within normal parameters | Greater than 10 breaths/min above normal parameters; accessory muscle use; 30% FiO2; 3 liters/minute | Greater than 20 breaths/min above normal parameters; retractions; | Below normal parameters with retractions; grunting; 50% FiO2; 8 liters/minute |
Table 3 Comparison of clinical characteristics between survivors and non-survivors (n = 113)
Variable | Survivors | Non-survivors | P value |
Age (yr), n (%) | 0.003 | ||
≤ 3 yr | 22 (25.6) | 0 (0.0) | |
3-6 yr (not including 3 yr) | 12 (13.4) | 3 (11.1) | |
6-12 yr (not including 6 yr) | 27 (31.2) | 10 (37.0) | |
> 12 yr | 25 (29.1) | 14 (51.9) | |
Sex, n (%) | 0.039 | ||
Female | 41 (47.7) | 19 (70.4) | |
Male | 45 (52.3) | 8 (29.6) | |
Cause of intoxication, n (%) | 0.585 | ||
Accidental | 68 (79.1) | 20 (74.1) | |
Suicide | 18 (20.9) | 7 (25.9) | |
Time to blood purification, n (%) | 0.185 | ||
< 6 h | 3 (5.0) | 2 (8.7) | |
6-12 h | 12 (20.0) | 7 (30.4) | |
12-24 h (not including 12 h) | 13 (21.7) | 5 (21.7) | |
> 24 h | 32 (53.3) | 9 (39.1) | |
Time to consultation, n (%) | 0.191 | ||
< 6 h | 28 (32.6) | 11 (40.7) | |
6-24 h | 22 (25.6) | 6 (22.2) | |
> 24 h | 36 (41.9) | 10 (37.1) | |
Vomiting, n (%) | 30 (34.9) | 19 (70.4) | 0.001 |
Abdominal pain, n (%) | 14 (16.3) | 9 (33.3) | 0.055 |
Oral ulcer, n (%) | 32 (37.2) | 16 (66.7) | 0.043 |
Gastrointestinal bleeding, n (%) | 3 (3.5) | 5 (18.5) | 0.001 |
WBC count (× 109/L) | 11.27 ± 4.57 | 15.45 ± 7.15 | 0.007 |
PLT count (× 109/L) | 267.79 ± 102.52 | 222.48 ± 79.15 | 0.038 |
ALT [M (P25, P75)] | 32.5 (25, 42) | 99 (41, 494) | < 0.001 |
AST [M (P25, P75)] | 28 (20, 40) | 108 (38, 295) | < 0.001 |
Albumin (g/L) | 44.34 ± 5.33 | 40.54 ± 6.23 | 0.002 |
Glucose (mmol/L) | 6.60 ± 3.43 | 6.75 ± 1.31 | 0.805 |
Na+ (mmol/L) | 137.04 ± 4.84 | 133.84 ± 6.49 | 0.024 |
K+ (mmol/L) | 3.72 ± 0.58 | 3.70 ± 0.668 | 0.882 |
Scr (mmol/L) | 74.17 ± 74.70 | 441.04 ± 267.86 | < 0.001 |
BUN (mmol/L) | 7.62 ± 6.65 | 23.06 ± 14.99 | < 0.001 |
PEWS, n (%) | < 0.001 | ||
0 | 66 (78.6) | 9 (33.3) | |
1 | 12 (14.0) | 9 (33.3) | |
2 | 5 (5.8) | 3 (11.1) | |
3 | 1 (1.1) | 3 (11.1) | |
4 | 1 (1.1) | 0 (0.0) | |
≥ 5 | 1 (1.1) | 3 (11.1) | |
PCIS | 95.57 ± 6.33 | 83.85 ± 7.74 | < 0.001 |
≤ 70, n (%) | 0 (0.0) | 2 (7.4) | |
71-80, n (%) | 6 (69.8) | 9 (33.3) | |
> 80, n (%) | 80 (93.0) | 16 (59.3) |
Table 4 Analysis of mortality due to paraquat poisoning using multivariate logistic regression (n = 113)
Variables | β Coefficient | SE | Odds ratio (95%CI) | P value |
ALT | 0.024 | 0.010 | 1.024 (1.003-1.045) | 0.022 |
PCIS | -0.151 | 0.046 | 0.860 (0.785-0.942) | 0.001 |
Table 5 Predictive value of risk factors for mortality in children with acute paraquat poisoning (n = 113)
Predictive factors | Sensitivity (%) | Specificity (%) | AUROC (95%CI) | Youden index | P value |
ALT | 59.26 | 96.51 | 0.814 (0.730-0.881) | 0.557 | < 0.001 |
PCIS | 92.30 | 82.21 | 0.905 (0.836-0.952) | 0.774 | < 0.001 |
ALT and PCIS | 92.59 | 87.21 | 0.937 (0.875-0.974) | 0.798 | < 0.001 |
- Citation: Song Y, Wang H, Tao YH. Risk factors and optimal predictive scoring system of mortality for children with acute paraquat poisoning. World J Clin Cases 2022; 10(15): 4799-4809
- URL: https://www.wjgnet.com/2307-8960/full/v10/i15/4799.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v10.i15.4799