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J Korean Soc Emerg Med > Volume 32(4); 2021 > Article
Journal of The Korean Society of Emergency Medicine 2021;32(4): 353-361.
급성 자리공 중독 환자의 임상 양상과 중증 중독과 관련된 인자
심동오1, 이재백1 , 진영호1 , 정태오1 , 김소은1 , 오태환1 , 이정문2, 윤재철1
1전북대학교병원 응급의학과
2전북대학교병원 외상팀
Clinical features of acute Phytolacca poisoning and factors associated with severe poisoning
Dong O Sim1, Jae Baek Lee1 , Young Ho Jin1 , Tae Oh Jeong1 , So Eun Kim1 , Tae Hwan Oh1 , Jeong Moon Lee2, Jae Chol Yoon1
1Department of Emergency Medicine, Jeonbuk National University Hospital, Jeonju, Korea
2Trauma Team, Jeonbuk National University Hospital, Jeonju, Korea
Correspondence  Jae Chol Yoon ,Tel: 063-250-1075, Fax: 063-250-1075, Email: jcyoon75@jbnu.ac.kr,
Received: September 25, 2020; Revised: November 13, 2020   Accepted: November 16, 2020.  Published online: August 31, 2021.
ABSTRACT
Objective:
This study evaluated the clinical features of acute Phytolacca poisoning and investigated the prognostic factors associated with severe poisoning.
Method:
This is a retrospective observational study using the data of patients presenting with acute Phytolacca poisoning. Demographic data, toxicological data, vital signs, laboratory data, and electrocardiographic data were collected. Study patients were divided into mild and severe poisoning patients. After a univariate analysis, binary logistic regression analysis, which used ‘severe poisoning’ as a dependent variable, was performed to figure out the independent variables. In addition, the area under the curve and the cut-off value of independent variables were suggested by using receiver operating characteristics analysis.
Results:
Most poisonings (80.5%) occurred in winter and spring. Most patients (98.4%) ingested the root of Phytolacca. It took 2 hours from ingestion to the beginning of the symptoms (interquartile range, 1.0-3.0) which included nausea/vomiting (98.4%), abdominal pain (58.6%), or diarrhea (53.1%). Severe poisoning developed in 21 patients (16.4%). For prediction of severe poisoning, the adjusted odds ratio of time from ingestion to the onset of symptoms was 0.18 (95% confidence interval [CI], 0.05-0.61) and that of the amount of ingestion was 1.42 (95% CI, 0.99-2.03). The area under the curve of time from ingestion to the onset of symptoms (≤1 hour) was 0.81 (95% CI, 0.73-0.88) and that of the amount of ingestion (>1.5 knuckles) was 0.75 (95% CI, 0.65-0.83).
Conclusion:
Acute Phytolacca poisoning has clinical features of acute enterocolitis. Severe poisoning could develop especially in patients with a rapid onset of symptoms (≤1 hour) and ingesting over 1.5 knuckles.
Key words: Phytolacca; Enterocolitis; Prognosis
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