Arterial lactate as a predictor of mortality in emergency department patients with paraquat intoxication

Context. Plasma paraquat concentration is recognized as the best prognostic indicator in patients with acute paraquat poisoning, but it cannot be measured in many hospitals due to limited medical resources. By contrast, arterial lactate is easily obtainable, even in local hospitals. Objective. To evaluate whether initial arterial lactate concentration is a good predictor of mortality in patients with acute paraquat poisoning. Materials and methods. A total of 272 patients with acute paraquat poisoning were admitted to the emergency department of Samsung Changwon Hospital from January 2005 to January 2011. Initial arterial lactate in the emergency department was compared in survivors and non-survivors. Initial arterial lactate and the Acute Physiology and Chronic Health Evaluation II (APACHE II) score system were compared by analyzing receiver operating characteristic (ROC) curves. Results. The overall rate of mortality was calculated to be 81.6%; 222 out of 272 patients died. The arterial lactate was high...