A Prospective Study to Assess the Profile and Outcome of Acute Paraquat Poisoning in a Tertiary Care Hospital of West Bengal.

Background and aims: Paraquat is a toxic herbicide, banned in several countries, but still being used extensively in India. Acute paraquat poisoning (APP) is associated with high case fatality. There is a dearth of prospective studies from India. Objectives of the study were to evaluate the profile and outcome of APP and to corroborate the findings of the urine dithionite test (UDT) with their clinical presentation. Patients and methods: This prospective study was undertaken over one year in 2023 in a tertiary care hospital setting. All clinically suspected adult APP cases that were admitted to the hospital were enrolled. Socio-demographic, poisoning profile, clinical features, investigations, and treatment received were recorded till outcome (death/discharge/left against medical advice). In addition, UDT was done on admission. Results: A total of 70 cases were enrolled with a median age of 25 years and male preponderance. The proportion of APP cases amongst all indoor admissions was 5.4 per 10,000. The majority were referral cases and had suicidal intent. Amount of poison consumed ranged from 2 to 250 mL with a median intake of 20 mL. In all cases tested, the UDT was positive. Out of the 39 patients in whom urine testing was done, 25 patients died, and all of them had an interpolated urine paraquat concentration ≥1 μg/mL. Case fatality rate was high, 74.28% (95% CI: 62.22-83.66%), and was attributed mainly to multi-organ failure (lung, liver, and kidney). Conclusion: In our study, it was found that APP was associated with a high case fatality rate and the development of multiorgan dysfunction. The findings of the UDT test corroborated with the clinical presentation. This study has generated evidence of the high burden of APP in our setting. This substantiates the need to consider banning it and promote the use of alternative, less toxic herbicides. How to cite this article: Kotal S, Chatterjee S, Pain S, Kundu AK. A Prospective Study to Assess the Profile and Outcome of Acute Paraquat Poisoning in a Tertiary Care Hospital of West Bengal. Indian J Crit Care Med 2025;29(8):677-683.