Association of annual percentage changes in anthropometric indices with all-cause mortality: a 14-year longitudinal study of older US adults.

Diquat is a fast-acting herbicide structurally similar to paraquat. Due to its widespread application in agriculture, the incidence of acute diquat poisoning has been on the rise in recent years. Although classified as moderately toxic by the World Health Organization, acute diquat poisoning can lead to severe manifestations like acute central nervous system injury (), acute kidney injury (, ), rhabdomyolysis (, ), multi-organ failure (, ), and even death (, ). The severity of poisoning is generally related to the dose consumed (). Although diquat poisoning may produce similar manifestations in children and adults, treatment decisions may be affected by physiological and metabolic differences (, ). In pediatric populations, ingestion of diquat may cause liver or kidney damage (), rhabdomyolysis and shock (), and fetal outcomes (), yet large-scale epidemiological evidence is scarce at home and abroad (, –). The dose-effect relationship, time course of organ damage, and key factors affecting prognosis remain unclear, which presents significant challenges in pediatric clinical decision-making. Based on the above background, we conducted a retrospective observational cohort study on 58 cases of acute diquat poisoning in children to address these gaps. We systematically summarized the clinical manifestations, laboratory and imaging characteristics of diquat poisoning in children, and focused on the relationship between the intake dose and multiple organ damage patterns, severity, and prognosis to provide an evidence-based basis for improving the diagnosis and treatment of diquat poisoning in children. Clinical data of children with acute diquat poisoning admitted to the intensive care unit of our hospital between August 2020 and December 2024 were collected. The inclusion criteria were as follows: 1) age ≥28 days and <18 years; 2) visit to our hospital within 72 h after taking diquat; and 3) patients should be clinically diagnosed with diquat poisoning, and blood/urine toxicology analysis results do not detect mixed other drugs and poisons. The exclusion criteria were as follows: 1) patients with previous liver or kidney dysfunction, heart disease, diabetes, respiratory system disease, genetic metabolic disease, nervous system disease, and other underlying diseases; 2) patients who have been confirmed by toxicological analysis to have mixed exposure to other toxins/drugs; 3) patients with incomplete medical records. Clinical data of patients were collected, including general information, intake routes and doses, clinical manifestations and laboratory examination indicators, imaging findings, treatments (including use of hemoperfusion and hemodialysis), length of stay, treatment costs, and condition at discharge. Collect the laboratory parameters of the patients at three time points after admission: T1 (within 24 h after admission), T2 (48–72 h after admission), and T3 (5–7 days after admission). Evaluation method of poison dosage: The hospital routinely assesses ingestion amounts in oral liquid poisoning cases through two approaches: accurate dose measurement and simulated ingestion evaluation. Accurate dose measurement: The patient orally stated the milliliters of diquat solution taken orally, or based on the capacity of the poison bottle and the volume of the remaining poison. Simulated ingestion evaluation: The patient simulated the poisoning event without swallowing, and spat water into a measuring cylinder. This was repeated three times to obtain an average volume.