Clinical features of acute <i>Phytolacca</i> poisoning and factors associated with severe poisoning

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