Mortality and associated risk factors in patients with severe methanol or ethylene glycol poisoning treated with dialysis: a retrospective cohort study

Author:

Kuusela Emma1ORCID,Järvisalo Mikko J.12ORCID,Hellman Tapio3,Uusalo Panu12ORCID

Affiliation:

1. Department of Anaesthesiology and Intensive Care, Turku University Hospital and University of Turku, Turku, Finland

2. Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital and University of Turku, Turku, Finland

3. Kidney Center, Turku University Hospital and University of Turku, Turku, Finland

Abstract

Objective To compare the initial clinical course and data on 90-day mortality in adults with methanol (MET) or ethylene glycol (EG) poisoning treated with dialysis. Methods Data on patient demographics and clinical parameters at intensive care unit (ICU) admission and for the first 24 hours after dialysis initiation were collected, and 90-day outcome data were collected for patients with MET (n = 15) or EG (n = 13) poisoning treated with dialysis in this retrospective cohort study. Results In univariate analysis, patients with EG poisoning were older and they had lower hourly urine output during the first 24 hours after the initiation of dialysis. Six (46%) patients with MET poisoning and three (20%) patients with EG poisoning died within 90 days of ICU admission. A larger anion gap and lower pH, bicarbonate levels, base excess, and Glasgow Coma Scale scores on admission, as well as the need for mechanical ventilation, were associated with 90-day mortality. Conclusions Metabolic acidosis, a large anion gap, and an altered mental status on admission appear to be associated with mortality in MET or EG poisoning, and EG poisoning may be linked to lower urine output.

Funder

Turun Yliopistollisen Keskussairaalan Koulutus- ja Tutkimussäätiö

Publisher

SAGE Publications

Subject

Biochemistry (medical),Cell Biology,Biochemistry,General Medicine

Reference24 articles.

1. Ashurst JV, Nappe TM. Methanol Toxicity. 2021 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. https://www.ncbi.nlm.nih.gov/books/NBK482121/. Accessed Sept 12, 2021.

2. Iqbal A, Glagola JJ, Nappe TM. Ethylene Glycol Toxicity. 2021 Aug 14. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. https://www.ncbi.nlm.nih.gov/books/NBK537009/. Accessed Sept 12, 2021

3. Extracorporeal Removal of Poisons and Toxins

4. Ethylene Glycol Toxicity

5. Ethylene glycol intoxication: Evaluation of kinetics and crystalluria

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