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Relationship between the start time of treatment and patient prognosis in cases of acute wild mushroom poisoning in a certain region of Guizhou Province, China from 2013 to 2020: A retrospective Observational Study and forecast

蘑菇中毒 医学 病死率 回顾性队列研究 蘑菇 死亡率 观察研究 爆发 内科学 急诊医学 毒物控制 儿科 流行病学 生物 病理 食品科学
作者
Caiyun Xia,Francesco Lai,Jin Wu,Jing‐Yu Zhan,Xiaojun Zhang,Xian Yu,Liao Ya,G. S. Zhang,Jie Hu,Tinggang Wang,Yuanlan Lu
出处
期刊:Human & Experimental Toxicology [SAGE Publishing]
卷期号:43 被引量:1
标识
DOI:10.1177/09603271241302192
摘要

Mushroom poisoning has been identified as a primary cause of both foodborne disease outbreaks and related fatalities in China. Depending on the mushroom species ingested, target-organ damage can usually be attributed to the toxins presenting in the mushroom species ingested, which can ultimately lead to organ failure and death. Developing a joint risk prediction model for death caused by acute mushroom poisoning could accurately predict the risk of mortality in such cases, early initiation of bundled treatment could significantly reduce mortality. Methods This single-center, retrospective observational study was conducted on 455 patients with Undergoing Treatment for Mushroom Poisoning at Affiliated Hospital of Zunyi Medical University (AHZMU), the tertiary governmental hospital of China, between January 2013 and December 2020. We investigated the impact of prognostic factors, including the mortality rate of patients who completed treatment at AHZMU versus those transferred to AHZMU, average length of hospital stay, mortality rate for a latency period of > 6-h, major damaged organs, HOPE6-TALK scoring and established a predictive model to assess the severity of acute mushroom poisoning. Results In 2013-2020, there are 455 patients of mushroom poisoning at AHZMU. Mushroom poisonings mainly concentrated in the summer and autumn months, resulted in 47 patients deaths. The first diagnosis cases at AHZMU resulting in a case fatality rate of 12.77% (6/47), Non-first diagnosis patients fatality accounting for 87.23% (41/47). The majority of deaths (89.36%) were attributed to liver injury. Death with incubation period >6-h accounting for 70.21% (33/47) of the total mortality rate. Logistic regression analysis revealed age and HOPE6 scores as independent risk factors, thereby establishing the logistic model equation, an examination via the ROC curve analysis indicates that a combination predictor values (Y coalition ) of 289.6 is the cut-off values for death resulting from acute mushroom poisoning. Conclusion The attending physician should conduct an early HOPE6-TALK scoring and calculate the Y coalition for patients with acute mushroom poisoning, as well as promptly identify the toxic mushrooms through morphological and molecular biological identification. Identify mushroom species and further infer the clinical type and clinical characteristics. For example, amanitoxion can cause acute liver injury with high mortality. Identify mushroom species that may cause organ damage so that timely implementation of the bundled therapy for poisonous mushrooms will increase the cure rate and reduce the mortality rate (Lu et al., 2019).
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