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Objective   Paraquat (PQ) is associated with high mortality rates in acute poisoning. This study aimed to determine the importance of the alveolar–arterial partial pressure difference (A-aDo 2 ) in the expected consequences of acute PQ poisoning.Methods   Patients who were hospitalized for PQ poisoning in 2018 were enrolled in this retrospective study. A-aDo 2  data were collected. Multivariate analysis was performed using binary logistic regression to determine whether A-aDo 2  is an independent risk factor for mortality from PQ.Results   A total of 352 cases were analyzed. The mean PQ dose was 36.84 ± 50.30 mL (0.3–500 mL). There were 185 survivors and 167 non-survivors. The mean A-aDo 2  was not significantly correlated between survivors and non-survivors on day 1. However, there were significant differences in A-aDo 2  between survivors and non-survivors on days 3, 7, 14, and 21. Increased A-aDo 2  values were correlated with an increased mortality rate. The mean A-aDo 2  on day 14 showed the most significant difference between survivors and non-survivors.Conclusion   Our study suggests that A-aDo 2  plays an important role as a reference index, which could be a useful predictor in assessing acute PQ poisoning, especially on the 14th day after onset of poisoning.

Alveolar–arterial partial pressure difference as an early predictor for patients with acute paraquat poisoning