Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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The Clinical Features and Prognostic Factors in Adults with Acute Etrodotoxin Poisoning Caused by Ingesting Puffer Fish

복어 섭취 후 발생한 급성 테트로도톡신 중독 환자의 임상적 특징과 예후 인자 분석

  • Jo, Yong Soo (Department of Emergency Medicine, Medical School, Chonnam National University) ;
  • Chun, Byeong Jo (Department of Emergency Medicine, Medical School, Chonnam National University) ;
  • Moon, Jeong Mi (Department of Emergency Medicine, Medical School, Chonnam National University) ;
  • Ryu, Hyun Ho (Department of Emergency Medicine, Medical School, Chonnam National University) ;
  • Jung, Yong Hun (Department of Emergency Medicine, Medical School, Chonnam National University) ;
  • Lee, Sung Min (Department of Emergency Medicine, Medical School, Chonnam National University) ;
  • Song, Kyung Hwan (Department of Emergency Medicine, Medical School, Chonnam National University) ;
  • Ryu, Jin Ho (Department of Emergency Medicine, Mokpo Jung-ang Hospital)
  • 조용수 (전남대학교 의과대학 응급의학교실) ;
  • 전병조 (전남대학교 의과대학 응급의학교실) ;
  • 문정미 (전남대학교 의과대학 응급의학교실) ;
  • 류현호 (전남대학교 의과대학 응급의학교실) ;
  • 정용훈 (전남대학교 의과대학 응급의학교실) ;
  • 이성민 (전남대학교 의과대학 응급의학교실) ;
  • 송경환 (전남대학교 의과대학 응급의학교실) ;
  • 류진호 (목포중앙병원 응급의학과)
  • Received : 2014.10.17
  • Accepted : 2014.11.02
  • Published : 2014.12.31
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Abstract

Purpose: We conducted this study in order to determine clinical features and prognostic factors in adults with acute tetrodotoxin (TTX) poisoning caused by ingestion of puffer fish. Methods: In this retrospective study, 107 patients were diagnosed with TTX poisoning. The subjects were divided into two groups according to duration of treatment; Group I, patients were discharged within 48 hours (n=76, 71.0%), Group II patients were discharged after more than 48 hours (n=31, 29.0%). Group II was subsequently divided into two subgroups [IIa (n=12, 11.2%), IIb (n=19, 17.8%)] according to the need for mechanical ventilation support. Results: In multivariable logistic regression analysis, the predictors of the need for treatment over 48 hours were dizziness (odds ratio [OR], 4.72; 95% confidence intervals [CI], 1.59-12.83), time interval between onset of symptom and ingestion (OR, 0.56; 95% CI, 0.16-0.97), $PaCO_2$<35 mmHg (OR, 8.37; 95% CI, 2.37-23.59). In addition, predictors of the need for mechanical ventilation were a time interval between onset of symptoms and ingestion (OR, 0.54; 95% CI, 0.11-0.96) and $PaCO_2$<35 mmHg (OR, 5.65; 95% CI, 1.96-18.66). Conclusion: Overall, dizziness, time interval between onset of symptoms and ingestion, ${\Delta}DBP$ and $PaCO_2$<35 mmHg predict the need for treatment over 48 hours, time interval between onset of symptoms and ingestion and $PaCO_2$<35 mmHg predict the need for mechanical ventilation support after acute TTX poisoning.

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