To investigate the evaluation value of early blood test indexes combined with lung high resolution computed tomography (HRCT) in the prognosis of patients with acute paraquat poisoning.

A retrospective analysis was carried out on the clinical blood tests and chest imaging data of 46 patients with acute paraquat poisoning admitted to the emergency department of Nanjing Drum Tower hospital from January 2015 to June 2020. In the death group, there were 12 males and 13 females; the average age was (45.36±18.56) years, ranging from 20 to 92 years. In survival group, there were 10 males and 11 females, their ages ranged from 14 to 71 years, with an average age of (40.52±14.33) years. The values of blood test indexes within 24 hours and the average lung CT number of chest HRCT after admission were collected; Binary logistic regression was used to analyze the risk factors for the prognosis of patients with acute paraquat poisoning, and ROC was drawn for the risk factors to analyze its effect on the death of patients with paraquat poisoning.

A total of 98 patients with acute paraquat poisoning were screened, and 46 patients who met the criteria were analyzed. Compared with patients in the survival group, the white blood cell count, neutrophil percentage, neutrophil count, neutrophil-to-lymphocyte ratio, AST, urea, creatinine of patients in the death group were significantly increased (P<0.01), lymphocyte percentage and lymphocyte count, EGFR (MDRD) were significantly reduced (P<0.01), but there was no significant difference in other blood test indexes (P>0.05). The AUC of blood test index values ranged from 0.74 to 0.89. Compared with the survival group, the average CT number of whole lung in the death group was higher, and the difference was statistically significant (P<0.001) with an AUC of 0.91 (95% CI 0.83~1.00). Binary logistic regression analysis showed that the combination of NLR, eGFR (MDRD) and the average CT number of whole lung was more effective than a single index in predicting the prognosis of patients with acute paraquat poisoning, with an AUC of 0.98 (95% CI 0.952~1.00). When the cut-off value for the combination of the three was -0.11, the sensitivity was 100%, the specificity was 96%, and the Youden index was 0.96.

This study shows that white blood cell count, neutrophil percentage, neutrophil count, lymphocyte percentage, lymphocyte count, NLR, AST, urea, creatinine and eGFR (MDRD) and the average lung CT number are all univariate predictors for the prognosis of patients with acute paraquat poisoning; while combined analysis of NLR, eGFR (MDRD)and the average lung CT number of whole lung can predict the prognosis of paraquat poisoning patients more accurately than single index.