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Peer-reviewedCC BYBMC emergency medicine

A decade of glyphosate-surfactant poisoning in India: clinical patterns and predictors of mortality.

  • Sanjan Asanaru Kunju1
  • Ahlam Abdul Rahman2
  • Sachin Nayak Sujir3
  • Vivek Gopinathan1
  • Bhanvi Prakash Ramchandani4
  • Sumedha Sircar4
4 affiliations
  1. 1Department of Emergency Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
  2. 2Department of Anaesthesiology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
  3. 3Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India. [email protected].
  4. 4Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
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Abstract

Background

Glyphosate-surfactant herbicide (GlySH) poisoning is increasingly reported in low- and middle-income countries, yet data on clinical predictors of mortality remain limited, particularly from the Indian subcontinent. This study aimed to describe the clinical profile of GlySH poisoning and to identify predictors of in-hospital mortality in a tertiary-care setting in South India.Methods

We conducted a retrospective observational study of consecutive adult patients with documented oral GlySH ingestion presenting to a tertiary-care emergency department between January 2009 and July 2019. Demographic, clinical, and laboratory variables were extracted from electronic medical records. In-hospital mortality was the primary outcome. Associations between clinical variables and mortality were assessed using Firth's penalised likelihood logistic regression and Fisher's exact test, with odds ratios (ORs) and 95% confidence intervals (CIs) reported. For predictors with complete separation, odds ratios were not estimable, and Fisher's exact p-values are reported. Multivariable analysis was not performed due to the small number of outcome events.Results

A total of 51 patients were included, of whom four (7.8%) died. Most patients were young adults (45.1% aged 25-44 years), male (76.5%), and had suicidal intent (64.7%). Shock (OR 14.67, 95% CI 1.50-143.74), altered sensorium (OR 14.63, 95% CI 1.34-159.23), elevated serum creatinine > 1.4 mg/dL (p = 0.0009), and dialysis requirement (p < 0.001) were associated with in-hospital mortality on univariate analysis. Elevated liver transaminases and respiratory distress were not significantly associated with mortality.Conclusion

In this 10-year cohort, mortality following GlySH poisoning was closely associated with shock, altered sensorium, and early renal dysfunction, reflecting advanced systemic toxicity. These readily identifiable features may assist in risk stratification and triage of high-risk patients in the emergency setting. Given the small number of outcome events, these findings should be interpreted as hypothesis-generating, and larger multicentric prospective studies are required to validate these predictors.

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Cite

BibTeXRIS
BibTeX
@article{kunju2026decade,
  title = {{A decade of glyphosate-surfactant poisoning in India: clinical patterns and predictors of mortality.}},
  author = {Sanjan Asanaru Kunju and Ahlam Abdul Rahman and Sachin Nayak Sujir and Vivek Gopinathan and Bhanvi Prakash Ramchandani and Sumedha Sircar},
  journal = {BMC emergency medicine},
  year = {2026},
  month = jul,
  doi = {10.1186/s12873-026-01696-4},
  url = {https://europepmc.org/article/MED/42902171},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - A decade of glyphosate-surfactant poisoning in India: clinical patterns and predictors of mortality.
AU  - Sanjan Asanaru Kunju
AU  - Ahlam Abdul Rahman
AU  - Sachin Nayak Sujir
AU  - Vivek Gopinathan
AU  - Bhanvi Prakash Ramchandani
AU  - Sumedha Sircar
PY  - 2026
DA  - 2026/07/01
JO  - BMC emergency medicine
DO  - 10.1186/s12873-026-01696-4
UR  - https://europepmc.org/article/MED/42902171
AB  - Background  Glyphosate-surfactant herbicide (GlySH) poisoning is increasingly reported in low- and middle-income countries, yet data on clinical predictors of mortality remain limited, particularly from the Indian subcontinent. This study aimed to describe the clinical profile of GlySH poisoning and to identify predictors of in-hospital mortality in a tertiary-care setting in South India.Methods  We conducted a retrospective observational study of consecutive adult patients with documented oral GlySH ingestion presenting to a tertiary-care emergency department between January 2009 and July 2019. Demographic, clinical, and laboratory variables were extracted from electronic medical records. In-hospital mortality was the primary outcome. Associations between clinical variables and mortality were assessed using Firth's penalised likelihood logistic regression and Fisher's exact test, with odds ratios (ORs) and 95% confidence intervals (CIs) reported. For predictors with complete separation, odds ratios were not estimable, and Fisher's exact p-values are reported. Multivariable analysis was not performed due to the small number of outcome events.Results  A total of 51 patients were included, of whom four (7.8%) died. Most patients were young adults (45.1% aged 25-44 years), male (76.5%), and had suicidal intent (64.7%). Shock (OR 14.67, 95% CI 1.50-143.74), altered sensorium (OR 14.63, 95% CI 1.34-159.23), elevated serum creatinine > 1.4 mg/dL (p = 0.0009), and dialysis requirement (p < 0.001) were associated with in-hospital mortality on univariate analysis. Elevated liver transaminases and respiratory distress were not significantly associated with mortality.Conclusion  In this 10-year cohort, mortality following GlySH poisoning was closely associated with shock, altered sensorium, and early renal dysfunction, reflecting advanced systemic toxicity. These readily identifiable features may assist in risk stratification and triage of high-risk patients in the emergency setting. Given the small number of outcome events, these findings should be interpreted as hypothesis-generating, and larger multicentric prospective studies are required to validate these predictors.
SN  - 1471-227X
ER  -