J Korean Soc Clin Toxicol.  2023 Jun;21(1):17-23. 10.22537/jksct.2023.00001.

Association between continuous renal replacement therapy and mortality after acute herbicide (glyphosate and/or glufosinate) intoxication: propensity score matching approach

• Lee SW
• Jeong Wj
• Ryu S
• Cho Y
• You Y
• Park JS
• Kang C
• Ahn HJ
• Jeon SY
• Lee J

• KMID: 2543422
• DOI: http://doi.org/10.22537/jksct.2023.00001

Abstract

Purpose
We investigated the association between continuous renal replacement therapy (CRRT) and mortality after acute glyphosate or glufosinate intoxication.
Methods
The electronic medical records of patients with acute herbicide ingestion who were admitted to the regional emergency center of a metropolitan city in Korea from 3/1/2013 to 2/28/2022 were analyzed and reviewed retrospectively. The case group received CRRT, while the control group did not. In total, 96 patients experienced acute herbicide intoxication in the study period. Baseline characteristics were analyzed and compared between the two groups after propensity score matching. The outcome variable was mortality fitted by a Cox proportional hazard model.
Results
After full matching between cases of CRRT use and controls (patients who did not receive CRRT) using propensity scores, 96 patients (27 cases, 69 controls) were analyzed. Propensity matching yielded adequate balance (standardized mean differences <0.25) for all covariates. We fit a Cox proportional hazards model with survival as the outcome and CRRT as a factor, including the matching weights in the estimation. The estimated hazard ratio was 0.41 (95% confidence interval, 0.23–0.76; p=0.0044), indicating that CRRT reduced mortality.
Conclusion
In this propensity score-matched analysis, CRRT reduced mortality in patients who visited the hospital with acute glyphosate or glufosinate intoxication. In patients with acute herbicide poisoning with high severity calculated by the APACHE II (Acute Physiology and Chronic Health Evaluation II) score and SOFA (Sequential Organ Failure Assessment) score, CRRT should be actively considered to improve the survival rate.