Retrospective Study of Paraquat Poisoning in the Khandesh Region: Clinical Outcomes and Mortality Predictors

Abstract

 Introduction:
Paraquat is a widely used non-selective herbicide in India, especially in rural agricultural regions, and is associated with high morbidity and mortality due to the absence of a specific antidote and rapid progression to multi-organ failure [1]. In North Maharashtra, agricultural dependency, easy availability of paraquat, and limited awareness of its toxicity contribute to frequent accidental or intentional exposures. This study was conducted to evaluate the demographic, clinical, laboratory, and treatment profiles of paraquat poisoning patients, along with their outcomes, to generate evidence for improving prevention and management strategies.

Methodology:
A hospital-based observational study was conducted at a tertiary care center in North Maharashtra, including 34 confirmed cases of paraquat poisoning admitted during the study period. Data were collected from patient medical records and included demographic details, presenting clinical signs, postmortem findings where applicable, laboratory investigations, treatment modalities, and outcomes. Statistical analysis was performed to determine the frequency and percentage distribution of variables.

Results:
The majority of patients were males (64.7%) and farmers (61.8%), with the highest incidence in the 21–30 years (23.5%) and 31–40 years (20.6%) age groups. Oral ulcers/mucosal burns were observed in 41.7% of cases, lung congestion in 58.3%, and kidney congestion in 52.8%. Laboratory abnormalities included elevated AST/ALT in 38.2%, hyperbilirubinemia (>2 mg/dL) in 41.2%, elevated creatinine in 52.9%, and low hemoglobin in 44.1%. Steroids were administered to 58.8% of patients, cyclophosphamide to 17.6%, and dialysis to 8.8%, while hemoperfusion was rarely used (2.9%). The overall in-hospital mortality was 61.8%, with multiorgan failure (71.4% of deaths) as the leading cause, followed by acute kidney injury (23.8%) and acute lung injury (4.8%).

Conclusion:
Paraquat poisoning in North Maharashtra predominantly affects young male farmers and carries a high mortality rate despite medical intervention. The study highlights the need for stricter regulation of paraquat sales, farmer education on its hazards, and improved access to advanced therapeutic measures such as hemoperfusion to reduce mortality.