The volume ratio of ground glass opacity in early lung CT predicts mortality in acute paraquat poisoning.
The volume ratio of ground glass opacity in early lung CT predicts mortality in acute paraquat poisoning.
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DOI：
10.1371/journal.pone.0121691
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Peng A
中科院分区：
文献类型：
--
作者：
Kang X;Hu DY;Li CB;Li XH;Fan SL;Liu Y;Tang GY;Ai ZS;Wu T;Mohan C;Zhou XJ;Liu JY;Peng A
肺损伤是急性百草枯中毒的主要死亡原因。然而，定量肺部计算机断层扫描（CT）是否可以在预测PQ中毒的结果仍然是未知的。我们的目的是确定定量肺部CT的早期发现作为急性PQ中毒的预后预测因子。肺CT扫描（64张）和定量CT病变前瞻性测量PQ中毒后5天内的患者。研究结局为90天随访期间的死亡率。生存曲线采用Kaplan-Meier法绘制，死亡危险因素采用前向逐步考克斯回归分析。97例患者中，41例（42.3%）死亡。中毒后第5天出现的8种不同的肺部CT表现中，有4种可区分存活者和死亡者，即磨玻璃样阴影（GGO）、实变、肺气肿和“无明显病变”。GGO体积比的临界值为10.8%，敏感性为85.4%，特异性为89.3%，在预测死亡率方面优于采用的结局指标，如PQ摄入量估计值，血浆或尿液PQ浓度，急性生理学和慢性健康评价（APACHE）II和序贯器官衰竭评估（SOFA）评分。GGO体积比高于10.8%与死亡率增加相关（风险比，5.82; 95%置信区间，4.77-7.09; P < 0.001）。GGO体积比超过10.8%是急性PQ中毒结局的一个新的、可靠的和独立的预测因子。
Pulmonary injury is the main cause of death in acute paraquat (PQ) poisoning. However, whether quantitative lung computed tomography (CT) can be useful in predicting the outcome of PQ poisoning remains unknown. We aimed to identify early findings of quantitative lung CT as predictors of outcome in acute PQ poisoning. Lung CT scanning (64-slide) and quantitative CT lesions were prospectively measured for patients after PQ intoxication within 5 days. The study outcome was mortality during 90 days follow-up. Survival curves were derived by the Kaplan-Meier method, and mortality risk factors were analyzed by the forward stepwise Cox regression analysis. Of 97 patients, 41 (42.3%) died. Among the eight different types of lung CT findings which appeared in the first 5-day of PQ intoxication, four ones discriminated between survivors and non-survivors including ground glass opacity (GGO), consolidation, pneumomediastinum and “no obvious lesion”. With a cutoff value of 10.8%, sensitivity of 85.4% and specificity of 89.3%, GGO volume ratio is better than adopted outcome indicators in predicting mortality, such as estimated amount of PQ ingestion, plasma or urine PQ concentration, acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores. GGO volume ratios above 10.8% were associated with increased mortality (hazard ratio, 5.82; 95% confidence interval, 4.77-7.09; P < 0.001). The volume ratio of GGO exceeding 10.8% is a novel, reliable and independent predictors of outcome in acute PQ poisoning.
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影响因子：
3.7
作者：
Weng CH;Hu CC;Lin JL;Lin-Tan DT;Huang WH;Hsu CW;Yen TH
通讯作者：
Yen TH
DOI：
10.1513/pats.200810-118qc
发表时间：
2008-12-15
期刊：
Proceedings of the American Thoracic Society
影响因子：
--
作者：
Coxson, Harvey O
通讯作者：
Coxson, Harvey O
DOI：
10.1056/nejmoa1007285
发表时间：
2011-03-10
期刊：
The New England journal of medicine
影响因子：
--
作者：
Washko GR;Hunninghake GM;Fernandez IE;Nishino M;Okajima Y;Yamashiro T;Ross JC;Estépar RS;Lynch DA;Brehm JM;Andriole KP;Diaz AA;Khorasani R;D'Aco K;Sciurba FC;Silverman EK;Hatabu H;Rosas IO;COPDGene Investigators
通讯作者：
COPDGene Investigators
影响因子：
3.3
作者：
Gil, Hyo-Wook;Kang, Mun-Soo;Hong, Sae-Yong
通讯作者：
Hong, Sae-Yong
影响因子：
5
作者：
Suzuki, Kenji;Epstein, Mark L.;Baron, Richard L.
通讯作者：
Baron, Richard L.