Arterial lactate in predicting mortality after paraquat poisoning: A meta-analysis

OBJECTIVE: This study aimed to explore the effects of arterial lactate as a predictor of mortality in patients with paraquat (PQ) poisoning. METHODS: The databases PubMed, EMBase, Web of Science, ScienceDirect, Cochrane library, and studies published until 31 February 2018 were searched. The data were extracted to perform pooled analysis, heterogeneity testing, sensitivity analysis, publication bias analysis, and Fagan plot analysis. RESULTS: Pooled analysis showed that a high arterial lactate was significantly correlated with poor mortality (pooled odds ratio = 16.94, 95% confidence interval [CI]: 7.96–36.08, P < .001). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 77% (95% CI: 0.69–0.84), 84% (95% CI: 0.74–0.90), 4.7 (95% CI: 2.9–7.8), 0.28 (95% CI: 0.20–0.39), and 17 (8–36), respectively. An area under the curve of 0.87 (95% CI: 0.83–0.89) means a high ability for prognostic detection. CONCLUSION: Our findings show that arterial lactate is an effective predictor of mortality in patients with PQ poisoning.