Risk factors of bromadiolone poisoning in the patients with unexplained coagulation dysfunction

Zheng Aiyi; Tang Shiyuan; Yao Rong

doi:10.3969/j.issn.1002-1949.2024.07.009

Abstract：Objective To explore the clinical features and risk factors of bromadiolone poisoning in the patients with unexplained coagulation dysfunction in order to provide the references for early diagnosis.Methods A retrospective research was conducted.The patients with unexplained coagulation dysfunction who visited to the emergency department of West China Hospital of Sichuan University from January 1,2018 to December 31,2023 were selected as the study subjects,and were divided into modeling group(n=254)and validation group(n=44)according to time.According to the results of bromadiolone detection,the patients were divided into bromadiolone positive group(n=53)and bromadiolone negative group(n=201).The basic features,bleeding site,laboratory findings(blood routine test,liver and kidney function,coagulation function and electrolyte indexes)were compared between the two groups.Then,the risk factors were analyzed by Lasso regression and multivariate Logistic regression analysis,and the model was established and verified.Results A total of 298 cases were included,of which 53 cases(20.87％)with bromadiolone detection were positive.Logistic regression analysis results showed that the skin and soft tissue bleeding,hemorrhage in respiratory system,urogenital tract bleeding,shortened thrombin time and D-dimer reduction were risk factors of bromadiolone poisoning in the patients with unexplained coagulation dysfunction(P＜0.05).Conclusions Bromadiolone poisoning is a common cause of unexplained coagulation dysfunction in emergency department.Patients with the skin and soft tissue bleeding,hemorrhage in respiratory system,urogenital tract bleeding,shortened thrombin time and D-dimer reduction should be especially alert to the possibility of bromadiolone poisoning,and is strongly recommended to undergo blood drug concentration screening.