Hyperamylasemia as an early predictor of mortality in patients with acute paraquat poisoning

Abstract

Objective This study aimed to evaluate the relationship between elevated serum amylase levels and the prognosis of paraquat poisoning. Methods Patients were categorized into the elevated and non-elevated serum amylase groups according to serum amylase levels. Demographics, mortality, risk factors of elevated serum amylase levels, and injury to the pancreas were analyzed. Results A total of 457 patients were enrolled in this study and the overall mortality rate was 51.9%. Patients in the elevated group had worse indices than those in the non-elevated group. Kaplan–Meier survival analysis showed that the mortality rate in the elevated group was significantly higher than that in the non-elevated group (hazard ratio: 10.65, 95% confidence interval [CI]: 7.55–15.02). Multivariate Cox proportional hazards analysis showed that elevated serum amylase levels were related to mortality (hazard ratio: 2.066, 95% CI: 1.239–3.444). The receiver operating characteristic curve showed that the area under the curve was 0.724 (95% CI: 0.666–0.783) for serum amylase levels with 70.4% sensitivity and 74.0% specificity. Conclusion Elevated serum amylase levels are observed in PQ poisoning. This elevation might be one of the most accurate early prognostic factors for predicting severity and mortality.