Risk factors for mortality in Asian Taiwanese patients with methanol poisoning

Abstract

IntroductionMethanol poisoning continues to be a serious public health issue in Taiwan, but very little work has been done to study the outcomes of methanol toxicity in the Asian population. In this study, we examined the value of multiple clinical variables in predicting mortality after methanol exposure.MethodsWe performed a retrospective observational study on patients with acute poisoning who were admitted to the Chang Gung Memorial Hospital over a period of 9 years (2000–2008). Out of the 6,347 patients, only 32 suffered methanol intoxication. The demographic, clinical, laboratory, and mortality data were obtained for analysis.ResultsMost patients were middle aged (46.1±13.8 years), male (87.5%), and habitual alcohol consumers (75.0%). All the poisonings were from an oral exposure (96.9%), except for one case of intentionally injected methanol (3.1%). After a latent period of 9.3±10.1 hours, many patients began to experience hypothermia (50.0%), hypotension (15.6%), renal failure (59.4%), respiratory failure (50.0%), and consciousness disturbance (Glasgow coma scale [GCS] score 10.5±5.4). Notably, the majority of patients were treated with ethanol antidote (59.4%) and hemodialysis (58.1%). The remaining 41.6% of patients did not meet the indications for ethanol therapy. At the end of analysis, there were six (18.8%), 15 (46.9%), and eleven (34.4%) patients alive, alive with chronic complications, and dead, respectively. In a multivariate Cox regression model, it was revealed that the GCS score (odds ratio [OR] 0.816, 95% confidence interval [CI] 0.682–0.976) (P=0.026), hypothermia (OR 168.686, 95% CI 2.685–10,595.977) (P=0.015), and serum creatinine level (OR 4.799, 95% CI 1.321–17.440) (P=0.017) were significant risk factors associated with mortality.ConclusionThe outcomes (mortality rate 34.4%) of the Taiwanese patients subjected to intensive detoxification protocols were comparable with published data from other international poison centers. Furthermore, the analytical results indicate that GCS score, hypothermia, and serum creatinine level help predict mortality after methanol poisoning.

Association between acute methanol poisoning and subsequent mortality: a nationwide study in Taiwan

“…In our study, the majority of patients with MP were middle-aged (35–49 years old) and males, which is compatible with previous studies [ 5 , 12 , 14 ]. A study in Czech recruiting 121 patients with MP reported that the mean age was 54 years (range: 16–79 years) and 80% of the patients were males [ 5 ].…”

Prediction and validation of hemodialysis duration in acute methanol poisoning

“…Generally, our cases consulted earlier and they were less acidotic at presentation as compared with what is generally reported in series of unintentional MP. 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 In our cohort, only one patient died and four patients had persistent visual abnormalities. The better prognosis of our cohort could also be explained by an unhindered access to ADH inhibitors and easier access to HD centers, which may be overwhelmed in epidemics.…”

“…The better prognosis of our cohort could also be explained by an unhindered access to ADH inhibitors and easier access to HD centers, which may be overwhelmed in epidemics. 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25…”

Acute Kidney Injury Predicts Mortality after Charcoal Burning Suicide

“…Finally, all primary data were collected according to the strengthening the reporting of observational studies in epidemiology guidelines. The studying method was used and based on previous studies 12 35 36 .…”