@2024 Afarand., IRAN
ISSN: 1027-1457 Scientific Journal of Forensic Medicine 2018;24(3):175-184
ISSN: 1027-1457 Scientific Journal of Forensic Medicine 2018;24(3):175-184
Evaluation of Effective Factors in the Prognosis of Hospitalized Patients with Acute Methanol Poisoning
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Navabi S.J. (1)Eivazi M. (*1)
Beiranvand B. (2)
(*1) Internal Department, Medicine Faculty, Kermanshah University of Medical Sciences, Kermanshah, Iran
(1) Internal Department, Medicine Faculty, Kermanshah University of Medical Sciences, Kermanshah, Iran
(2) Biostatistics & Epidemiology Department, Health Faculty, Lorestan University of Medical Sciences, Khoramabad, Iran
Correspondence
Address: Internal Department, Medicine Faculty, Kermanshah University of Medical Sciences, Kermanshah, Iran.Phone: +98-83-37249179
Fax:
meivazi66@yahoo.com
Article History
Received: September 5, 2016Accepted: May 10, 2017
ePublished: December 20, 2018
ABSTRACT
Aims
Every year, many people come to emergency care due to methanol poisoning and receive healthcare services. Therefore, the aim of this study was to investigate the effective factors in the prognosis of patients with acute methanol poisoning admitted to Imam Khomeini Hospital in Kermanshah during 2010-1015.
Instrument & Methods This is a retrospective descriptive-analytic study. Sampling was done by census method. The study population included patients with acute methanol poisoning referring to Imam Khomeini Hospital in Kermanshah from 2010 to 2015. The required information including age, gender, date of referral, times interval until patient referral, clinical signs and symptoms of ECG symptoms, type of treatment and eventual poisoning from medical records and phone call with patients referring to Imam Khomeini Hospital were collected by filling in the relevant checklist. The data were analyzed by SPSS 22. Mann-Whitney test, Chi-square test or Fisher exact test, and multivariate logistic regression were used.
Findings 188 (96.5%) of the patients were male and 7 (3.5%) were female. The mortality rate of the patients was 12.5%. There was a significant relationship among mortality rate and age, clinical symptoms (including coma, blurred vision, pupil size, nausea, and vomiting), laboratory symptoms (including urea, creatinine, glucose, AST, ALT, CPK, LDH, pH, and bicarbonate), non-cardiac rhythms, prescription of ethanol, folic acid, corticosteroid and bicarbonate, and conducting, the frequency, and duration of dialysis (p<0.05).
Conclusion Consciousness level, creatinine level, and pH of methanol-poisoned patients when admitted to the emergency department can predict the outcome of treatment and the mortality situation
Instrument & Methods This is a retrospective descriptive-analytic study. Sampling was done by census method. The study population included patients with acute methanol poisoning referring to Imam Khomeini Hospital in Kermanshah from 2010 to 2015. The required information including age, gender, date of referral, times interval until patient referral, clinical signs and symptoms of ECG symptoms, type of treatment and eventual poisoning from medical records and phone call with patients referring to Imam Khomeini Hospital were collected by filling in the relevant checklist. The data were analyzed by SPSS 22. Mann-Whitney test, Chi-square test or Fisher exact test, and multivariate logistic regression were used.
Findings 188 (96.5%) of the patients were male and 7 (3.5%) were female. The mortality rate of the patients was 12.5%. There was a significant relationship among mortality rate and age, clinical symptoms (including coma, blurred vision, pupil size, nausea, and vomiting), laboratory symptoms (including urea, creatinine, glucose, AST, ALT, CPK, LDH, pH, and bicarbonate), non-cardiac rhythms, prescription of ethanol, folic acid, corticosteroid and bicarbonate, and conducting, the frequency, and duration of dialysis (p<0.05).
Conclusion Consciousness level, creatinine level, and pH of methanol-poisoned patients when admitted to the emergency department can predict the outcome of treatment and the mortality situation
CITATION LINKS
[1]Kleiman R, Nickle R, Schwartz M. Medical toxicology and public health - update on research and activities at the centers for disease control and prevention, and the agency for toxic substances and disease registry. J Med Toxicol. 2009;5(3):158-64.
[2]Blanco M, Casado R, Vázquez F, Pumar JM. CT and MR imaging findings in methanol intoxication. AJNR Am J Neuroradiol. 2006;27(2):452-4.
[3]Galvez-Ruiz A, Elkhamary SM, Asghar N, Bosley TM. Visual and neurologic sequelae of methanol poisoning in Saudi Arabia. Saudi Med J. 2015;36(5):568-74.
[4]Gupta N, Sonambekar AA, Daksh SK, Tomar L. A rare presentation of methanol toxicity. Ann Indian Acad Neurol. 2014;17(1):142.
[5]Singh A, Samson R, Girdhar A. Portrait of a methanol-intoxicated brain. Am J Med. 2011;124(2):125-7.
[6]Torabi M, Shafiei M. Necrosis of the putamen, globus pallidus and parkinsonian disorder caused by methanol intoxication. Avicenna J Clin Med. 2012;18(4):73-6. [Persian]
[7] Salek T, Humpolicek P, Ponizil P. Metabolic disorders due to methanol poisoning. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014;158(4):635-9.
[8]Paasma R, Hovda KE, Hassanian Moghaddam H, Brahmi N, Afshari R, Sandvik L, et al. Risk factors related to poor outcome after methanol poisoning and the relation between outcome and antidotes--a multicenter study. Clin Toxicol (Phila). 2012;50(9):823-31.
[9]Sanaei Zadeh H. Is high-dose intravenous steroid effective on preserving vision in acute methanol poisoning?. Optom Vis Sci. 2012;89(2):244.
[10]Desai T, Sudhalkar A, Vyas U, Khamar B. Methanol poisoning: Predictors of visual outcomes. JAMA Ophthalmol. 2013;131(3):358-64.
[11]Hosseiniyan Moghadam H, Norouzi AR, Balali Mood M, Saberi Zafarghandi MB, Abdollahi M, Gilani Pour M, et al. Clinical guideline for treatment of methanol poisoning. Tehran: Noor Giti; 2009. [Persian]
[12]Sanaei Zadeh H, Esfeh SK, Zamani N, Jamshidi F, Shadnia S. Hyperglycemia is a strong prognostic factor of lethality in methanol poisoning. J Med Toxicol. 2011;7(3):189-94.
[13]Massoumi G, Saberi K, Eizadi Mood N, Shamsi M, Alavi M, Morteza A. Methanol poisoning in Iran, from 2000 to 2009. Drug Chem Toxicol. 2012;35(3):330-3.
[14]Desai T, Sudhalkar A, Vyas U, Khamar B. Methanol poisoning: predictors of visual outcomes. JAMA Ophthalmol. 2013;131(3):358-64.
[15]Sanaei Zadeh H, Emamhadi M, Farajidana H, Zamani N, Amirfarhangi A. Electrocardiographic manifestations in acute methanol poisoning cannot predict mortality. Arh Hig Rada Toksikol. 2013;64(2):79-85.
[16]Shadnia S, Rahimi M, Soltaninejad K, Nilli A. Role of clinical and paraclinical manifestations of methanol poisoning in outcome prediction. J Res Med Sci. 2013;18(10):865-9.
[17]Bahreini Moghaddam SA, Pajoumand A. Prognostic factors including clinical manifestation and paraclinic finding in sever methanol toxicity. Life Sci J. 2014;11(2s):11-4.
[18]Morteza Bagi HR, Tagizadieh M, Moharamzadeh P, Pouraghaei M, Kahvareh Barhagi A, Shahsavari Nia K. Epidemiology of alcohol poisoning and its outcome in the North-West of Iran. Emerg (Tehran). 2015;3(1):27-32.
[19]Coulter CV, Farquhar SE, Mc Sherry CM, Isbister GK, Duffull SB. Methanol and ethylene glycol acute poisonings - predictors of mortality. Clin Toxicol (Phila). 2011;49(10):900-6.
[20]Kute VB, Godara SM, Shah PR, Gumber MR, Goplani KR, Vanikar AV, et al. Hemodialysis for methyl alcohol poisoning: A single-center experience. Saudi J Kidney Dis Transpl. 2012;23(1):37-43.
[21]Zakharov S, Pelclova D, Urban P, Navratil T, Diblik P, Kuthan P, et al. Czech mass methanol outbreak 2012: Epidemiology, challenges and clinical features. Clin Toxicol (Phila). 2014;52(10):1013-24.
[22]Lee CY, Chang EK, Lin JL, Weng CH, Lee SY, Juan KC, et al. Risk factors for mortality in Asian Taiwanese patients with methanol poisoning. The Clin Risk Manag. 2014;10:61-7.
[23]Paasma R. Clinical study of methanol poisoning: Handling large outbreaks, treatment with antidotes, and long-term outcomes [Dissertation]. Tartu: University of Tartu Press; 2013.
[24]Hovda KE, Hunderi OH, Tafjord AB, Dunlop O, Rudberg N, Jacobsen D. Methanol outbreak in Norway 2002-2004: Epidemiology, clinical features and prognostic signs. J Intern Med. 2005;258(2):181-90.
[25]Paasma R, Hovda KE, Tikkerberi A, Jacobsen D. Methanol mass poisoning in Estonia: Outbreak in 154 patients. Clin Toxicol (Phila). 2007;45(2):152-7.
[26]Hassanian Moghaddam H, Pajoumand A, Dadgar SM, Shadnia Sh. Prognostic factors in methanol poisoning. Hum Exp Toxicol. 2007;26(7):583-6.
[27] Rzepecki J, Krakowiak A, Fiszer M, Czyzewska S, Winnicka R, Kołaciński Z, et al. Acute methanol poisoning among patients of Toxicology Unit, Nofer Institute of Occupational Medicine in Łódź, during the period 2000-2009. Przegla̧d Lekarski. 2012;69(8):431-4. [Polish]
[28]Zakharov S, Pelclova D, Navratil T, Belacek J, Komarc M, Eddleston M, et al. Fomepizole versus ethanol in the treatment of acute methanol poisoning: Comparison of clinical effectiveness in a mass poisoning outbreak. Clin Toxicol (Phila). 2015;53(8):797-806.
[2]Blanco M, Casado R, Vázquez F, Pumar JM. CT and MR imaging findings in methanol intoxication. AJNR Am J Neuroradiol. 2006;27(2):452-4.
[3]Galvez-Ruiz A, Elkhamary SM, Asghar N, Bosley TM. Visual and neurologic sequelae of methanol poisoning in Saudi Arabia. Saudi Med J. 2015;36(5):568-74.
[4]Gupta N, Sonambekar AA, Daksh SK, Tomar L. A rare presentation of methanol toxicity. Ann Indian Acad Neurol. 2014;17(1):142.
[5]Singh A, Samson R, Girdhar A. Portrait of a methanol-intoxicated brain. Am J Med. 2011;124(2):125-7.
[6]Torabi M, Shafiei M. Necrosis of the putamen, globus pallidus and parkinsonian disorder caused by methanol intoxication. Avicenna J Clin Med. 2012;18(4):73-6. [Persian]
[7] Salek T, Humpolicek P, Ponizil P. Metabolic disorders due to methanol poisoning. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014;158(4):635-9.
[8]Paasma R, Hovda KE, Hassanian Moghaddam H, Brahmi N, Afshari R, Sandvik L, et al. Risk factors related to poor outcome after methanol poisoning and the relation between outcome and antidotes--a multicenter study. Clin Toxicol (Phila). 2012;50(9):823-31.
[9]Sanaei Zadeh H. Is high-dose intravenous steroid effective on preserving vision in acute methanol poisoning?. Optom Vis Sci. 2012;89(2):244.
[10]Desai T, Sudhalkar A, Vyas U, Khamar B. Methanol poisoning: Predictors of visual outcomes. JAMA Ophthalmol. 2013;131(3):358-64.
[11]Hosseiniyan Moghadam H, Norouzi AR, Balali Mood M, Saberi Zafarghandi MB, Abdollahi M, Gilani Pour M, et al. Clinical guideline for treatment of methanol poisoning. Tehran: Noor Giti; 2009. [Persian]
[12]Sanaei Zadeh H, Esfeh SK, Zamani N, Jamshidi F, Shadnia S. Hyperglycemia is a strong prognostic factor of lethality in methanol poisoning. J Med Toxicol. 2011;7(3):189-94.
[13]Massoumi G, Saberi K, Eizadi Mood N, Shamsi M, Alavi M, Morteza A. Methanol poisoning in Iran, from 2000 to 2009. Drug Chem Toxicol. 2012;35(3):330-3.
[14]Desai T, Sudhalkar A, Vyas U, Khamar B. Methanol poisoning: predictors of visual outcomes. JAMA Ophthalmol. 2013;131(3):358-64.
[15]Sanaei Zadeh H, Emamhadi M, Farajidana H, Zamani N, Amirfarhangi A. Electrocardiographic manifestations in acute methanol poisoning cannot predict mortality. Arh Hig Rada Toksikol. 2013;64(2):79-85.
[16]Shadnia S, Rahimi M, Soltaninejad K, Nilli A. Role of clinical and paraclinical manifestations of methanol poisoning in outcome prediction. J Res Med Sci. 2013;18(10):865-9.
[17]Bahreini Moghaddam SA, Pajoumand A. Prognostic factors including clinical manifestation and paraclinic finding in sever methanol toxicity. Life Sci J. 2014;11(2s):11-4.
[18]Morteza Bagi HR, Tagizadieh M, Moharamzadeh P, Pouraghaei M, Kahvareh Barhagi A, Shahsavari Nia K. Epidemiology of alcohol poisoning and its outcome in the North-West of Iran. Emerg (Tehran). 2015;3(1):27-32.
[19]Coulter CV, Farquhar SE, Mc Sherry CM, Isbister GK, Duffull SB. Methanol and ethylene glycol acute poisonings - predictors of mortality. Clin Toxicol (Phila). 2011;49(10):900-6.
[20]Kute VB, Godara SM, Shah PR, Gumber MR, Goplani KR, Vanikar AV, et al. Hemodialysis for methyl alcohol poisoning: A single-center experience. Saudi J Kidney Dis Transpl. 2012;23(1):37-43.
[21]Zakharov S, Pelclova D, Urban P, Navratil T, Diblik P, Kuthan P, et al. Czech mass methanol outbreak 2012: Epidemiology, challenges and clinical features. Clin Toxicol (Phila). 2014;52(10):1013-24.
[22]Lee CY, Chang EK, Lin JL, Weng CH, Lee SY, Juan KC, et al. Risk factors for mortality in Asian Taiwanese patients with methanol poisoning. The Clin Risk Manag. 2014;10:61-7.
[23]Paasma R. Clinical study of methanol poisoning: Handling large outbreaks, treatment with antidotes, and long-term outcomes [Dissertation]. Tartu: University of Tartu Press; 2013.
[24]Hovda KE, Hunderi OH, Tafjord AB, Dunlop O, Rudberg N, Jacobsen D. Methanol outbreak in Norway 2002-2004: Epidemiology, clinical features and prognostic signs. J Intern Med. 2005;258(2):181-90.
[25]Paasma R, Hovda KE, Tikkerberi A, Jacobsen D. Methanol mass poisoning in Estonia: Outbreak in 154 patients. Clin Toxicol (Phila). 2007;45(2):152-7.
[26]Hassanian Moghaddam H, Pajoumand A, Dadgar SM, Shadnia Sh. Prognostic factors in methanol poisoning. Hum Exp Toxicol. 2007;26(7):583-6.
[27] Rzepecki J, Krakowiak A, Fiszer M, Czyzewska S, Winnicka R, Kołaciński Z, et al. Acute methanol poisoning among patients of Toxicology Unit, Nofer Institute of Occupational Medicine in Łódź, during the period 2000-2009. Przegla̧d Lekarski. 2012;69(8):431-4. [Polish]
[28]Zakharov S, Pelclova D, Navratil T, Belacek J, Komarc M, Eddleston M, et al. Fomepizole versus ethanol in the treatment of acute methanol poisoning: Comparison of clinical effectiveness in a mass poisoning outbreak. Clin Toxicol (Phila). 2015;53(8):797-806.