Background: Paraquat is a highly toxic, nonselective herbicide widely used in agriculture in low- and middle-income countries, including India. Ingestion is frequently associated with fulminant multi-organ failure and high mortality. This study describes the clinical, radiological, and biochemical profile of patients with paraquat poisoning and identifies prognostic factors associated with mortality. Methods: A retrospective observational study was conducted at a tertiary care center in eastern India. Adult patients admitted with paraquat poisoning to the Respiratory Intensive Care Unit between June and December 2024 were included. Demographic characteristics, intent of ingestion, radiological findings, biochemical parameters, respiratory support requirements, and in-hospital outcomes were analyzed. Results: Twenty-two patients were included (mean age 41.77 ± 12.9 years; 72.7% males). Suicidal ingestion accounted for 81.8% of cases. High-resolution computed tomography (HRCT) of the thorax was performed in 18 patients, revealing ground-glass opacities in 63.6% and pulmonary fibrosis in 18.2%. Overall mortality was 77.3%. All patients who required invasive mechanical ventilation died. Mortality was universal among patients with serum creatinine ≥5 mg/dL and among those with fibrotic changes on HRCT. Higher age, serum urea, serum creatinine, and HRCT-documented fibrosis were significantly associated with mortality. Conclusion: Paraquat poisoning is associated with extremely high mortality. Elevated serum creatinine (≥5 mg/dL), pulmonary fibrosis on HRCT, and the requirement for invasive mechanical ventilation are strong predictors of poor outcome. Early identification of these features may aid prognostication and clinical decision-making.
Pandey et al. (Thu,) studied this question.