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Retrospective Analysis of Methyl Alcohol Poisonings Admitted to the Emergency Department

Year 2022, , 503 - 511, 20.10.2022
https://doi.org/10.18521/ktd.1147742

Abstract

Objective: Methyl alcohol poisoning remains a significant cause of mortality and morbidity. This poisoning is still one of the important reasons for admission to emergency services. We aimed to examine the admission complaints, laboratory findings, treatment methods, clinical outcomes and examine the factors affecting the mortality of patients diagnosed with methyl alcohol poisoning in the emergency department.
Methods: In this retrospective descriptive study, we analysed the patients who were considered to be diagnosed with methyl alcohol intoxication among those who came to our emergency department due to alcohol intoxication from June 1, 2018 to June 1, 2020.
Results: The study included 20 (4.86%) individuals with methyl alcohol poisoning among 411 people who presented to the emergency department due to ethyl and methyl alcohol intake and resulting effects.The mean age of the patients was 47.35±14.2 years and 85% (n=17/20) were male. Upon reviewing the patients' admission symptoms, 70% were observed to have visual problems, 60% complaints of vomiting, 45% shortness of breath, and 40% changes in consciousness. In the study, it was revealed that 18.2%(n=2/11) females and 81.8%(n=9/11) males died, and the mortality rate was calculated as 55%(n=11/20).
Conclusions: The presence of visual problems, hypotension, and coma in clinical findings, high anion gap metabolic acidosis, marked osmolar gap, an increase in lactate level, and hyperglycemia in laboratory findings may be the early signs of mortality in patients with methyl alcohol poisoning. Therefore, patients with these signs should be followed up more closely and treated.

Thanks

We would like to thank the emergency department staff of Kayseri City Hospital who had to work in difficult conditions.

References

  • Spirit P, Alcohol W, Naphtha W, Spirit W. Final Report on the Safety Assessment of Methyl Alcohol. Int J Toxicol. 2001;20(1):57–85.
  • Jacobsen D, McMartin KE. Antidotes for methanol and ethylene glycol poisoning. J Toxicol Clin Toxicol. 1997;35(2):127–43.
  • Najari F, Baradaran I, Najari D. Methanol Poisoning and Its Treatment. Int J Med Toxicol Forensic Med. 2020;10(1):26639.
  • Kurtas O, Imre KY, Ozer E, Can M, Birincioglu I, Butun C, et al. The evaluation of deaths due to methyl alcohol intoxication. Biomed Res. 2017;28(8):3680–7.
  • Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol. 2002;40(4):415–46.
  • Nekoukar Z, Zakariaei Z, Taghizadeh F, Musavi F, Banimostafavi SE, Sharifpour A, et al. Methanol poisoning as a new world challenge: A review. Ann Med Surg. 2021;66:102445.
  • Banagozar MA, Delirrad M. Problems with Methanol Poisoning Outbreaks in Iran. Alcohol and Alcoholism, 2019;54(3): 338.
  • Hovda KE, Hunderi OH, Rudberg N, Froyshov S, Jacobsen D. Anion and osmolal gaps in the diagnosis of methanol poisoning: clinical study in 28 patients. Intensive Care Med. 2004 Sep;30(9):1842–6.
  • Yousefinejad V, Moradi B, Baneh AM, Sheikhesmaeili F, Babahajian A. Prognostic Factors of Outcome in Methanol Poisoning; an 8-year Retrospective Cross-sectional Study. Arch Acad Emerg Med. 2020;8(1):e69.
  • Holzman SD, Larsen J, Kaur R, Smelski G, Dudley S, Shirazi FM. Death by hand sanitizer: Syndemic methanol poisoning in the age of COVID-19. Clin Toxicol. 2021;59(11):1009–14.
  • Manning L, Kowalska A. Illicit alcohol: Public health risk of methanol poisoning and policy mitigation strategies. Foods. 2021;10(7):1625.
  • Aghababaeian H, Ahvazi LA, Ostadtaghizadeh A. The Methanol Poisoning Outbreaks in Iran 2018. Alcohol and Alcoholism, 2019, 54(2) 128–130.
  • Kacer I, Caglar A. A growing problem of methanol poisonings: A retrospective analysis of 47 patients in a single-centre in Turkey. Ann Med Res. 2021;28(12):2179–82.
  • Kalkan S, Cevik AA, Cavdar C, et al. Acute methanol poisonings reported to the Drug and Poison Information Center in Izmir, Turkey. Vet Hum Toxicol. 2003 Dec;45(6):334–7.
  • Hadipourzadeh M, Ebrahimi S, Ziaeefar P, Zamani N, Falahaty H, Robert D, et al. Comparing the Clinical Characteristics, Laboratory Findings, and Outcomes between Epidemic and Episodic Methanol Poisoning Referrals; a Cross-sectional Study. Arch Acad Emerg Med. 2021;9(1).
  • Graw M, Haffner HT, Althaus L, Besserer K, Voges S. Invasion and distribution of methanol. Arch Toxicol. 2000 Aug;74(6);p.313–21.
  • Wiener SW. Toxic Alcohols. Goldfrank’s Toxicol Emergencies. Hoffman, RS, Howland, MA, Lewin, NA, Nelson, LS, Goldfrank, LR, Eds. 10th ed.Mc Graw Hill; 2015;p.1346–58.
  • Rietjens SJ, de Lange DW, Meulenbelt J. Ethylene glycol or methanol intoxication: which antidote should be used, fomepizole or ethanol? Neth J Med. 2014 Feb;72(2):73–9.
  • Tian M, He H, Liu Y, Li R, Zhu B, Cao Z. Fatal methanol poisoning with different clinical and autopsy findings: Case report and literature review. Leg Med. 2022;54:101995.
  • Brahmi N, Blel Y, Abidi N, Kouraichi N, Thabet H, Hedhili A, et al. Methanol poisoning in Tunisia: report of 16 cases. Clin Toxicology (Phila). 2007;45(6):717–20.
  • Karimi S, Arabi A, Shahraki T. Alcohol and the Eye. J Ophthalmic Vis Res. 2021;16(2):260.
  • 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 Toxicology (Phila). 2012 Nov;50(9):823–31.
  • Desai T, Sudhakar A, Vyas U, Khamar B. Methanol poisoning: predictors of visual outcomes. JAMA Ophthalmol. 2013 Mar;131(3):358–64.
  • Kute VB, Godara SM, Shah PR, Gumber MR, Goplani KR, Vanikar AV, et al. Hemodialysis for methyl alcohol poisoning: A single-centre experience. Saudi J Kidney Dis Transpl 2012;23:37-43.
  • Hantson P, Mahieu P. Pancreatic injury following acute methanol poisoning. J Toxicol Clin Toxicol. 2000;38(3):297–303.
  • Mégarbane B. Treatment of patients with ethylene glycol or methanol poisoning: focus on fomepizole. Open Access Emerg Med. 2010;2:67–75.
  • Julian T, Glascow N, Syeed R, Zis P. Alcohol-related peripheral neuropathy: a systematic review and meta-analysis. J Neurol. 2019 Dec;266(12):2907–19.

Acil Servise Başvuran Metil Alkol Zehirlenmelerinin Geriye Dönük Analizi

Year 2022, , 503 - 511, 20.10.2022
https://doi.org/10.18521/ktd.1147742

Abstract

Amaç: Metil alkol zehirlenmesi önemli bir mortalite ve morbidite nedeni olmaya devam etmektedir. Bu zehirlenme halen acil servislere başvurunun önemli nedenlerinden biridir. Bu çalışmada acil serviste metil alkol zehirlenmesi tanısı alan hastaların başvuru şikayetlerini, laboratuvar bulgularını, tedavi yöntemlerini, klinik sonuçlarını ve mortaliteyi etkileyen faktörleri incelemeyi amaçladık.
Metod: Bu retrospektif tanımlayıcı çalışmada 1 Haziran 2018 ile 1 Haziran 2020 tarihleri arasında alkol zehirlenmesi nedeniyle acil servisimize başvuran hastalardan metil alkol zehirlenmesi tanısı düşünülen hastaları inceledik.
Bulgular: Çalışmaya etil ve metil alkol alımı ve buna bağlı etkiler nedeniyle acil servise başvuran 411 kişiden metil alkol zehirlenmesi olan 20 kişi (%4.86) dahil edildi. Hastaların yaş ortalaması 47.35±14,2 yıl olup, %85'i (n=17/20) erkekti. Hastaların başvuru semptomları incelendiğinde %70'inde görme problemi, %60'ında kusma, %45'inde nefes darlığı ve %40'ında bilinç değişikliğinin olduğu görüldü. Araştırmada %18.2(n=2/11) kadın ve %81.8(n=9/11) erkekte ölüm saptanmış olup, ölüm oranı %55(n=11/20) olarak hesaplanmıştır.
Sonuç: Metil alkol zehirlenmesi olan hastalarda klinik ve laboratuvar bulgularında; görme sorunları, hipotansiyon ve koma, yüksek anyon açıklı metabolik asidoz, belirgin ozmolar boşluk, laktat düzeyinde artış ve hiperglisemi varlığı mortalitenin erken belirtileri olabilir. Bu nedenle bu belirtileri olan hastalar daha yakın takip ve tedavi edilmelidir.

References

  • Spirit P, Alcohol W, Naphtha W, Spirit W. Final Report on the Safety Assessment of Methyl Alcohol. Int J Toxicol. 2001;20(1):57–85.
  • Jacobsen D, McMartin KE. Antidotes for methanol and ethylene glycol poisoning. J Toxicol Clin Toxicol. 1997;35(2):127–43.
  • Najari F, Baradaran I, Najari D. Methanol Poisoning and Its Treatment. Int J Med Toxicol Forensic Med. 2020;10(1):26639.
  • Kurtas O, Imre KY, Ozer E, Can M, Birincioglu I, Butun C, et al. The evaluation of deaths due to methyl alcohol intoxication. Biomed Res. 2017;28(8):3680–7.
  • Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol. 2002;40(4):415–46.
  • Nekoukar Z, Zakariaei Z, Taghizadeh F, Musavi F, Banimostafavi SE, Sharifpour A, et al. Methanol poisoning as a new world challenge: A review. Ann Med Surg. 2021;66:102445.
  • Banagozar MA, Delirrad M. Problems with Methanol Poisoning Outbreaks in Iran. Alcohol and Alcoholism, 2019;54(3): 338.
  • Hovda KE, Hunderi OH, Rudberg N, Froyshov S, Jacobsen D. Anion and osmolal gaps in the diagnosis of methanol poisoning: clinical study in 28 patients. Intensive Care Med. 2004 Sep;30(9):1842–6.
  • Yousefinejad V, Moradi B, Baneh AM, Sheikhesmaeili F, Babahajian A. Prognostic Factors of Outcome in Methanol Poisoning; an 8-year Retrospective Cross-sectional Study. Arch Acad Emerg Med. 2020;8(1):e69.
  • Holzman SD, Larsen J, Kaur R, Smelski G, Dudley S, Shirazi FM. Death by hand sanitizer: Syndemic methanol poisoning in the age of COVID-19. Clin Toxicol. 2021;59(11):1009–14.
  • Manning L, Kowalska A. Illicit alcohol: Public health risk of methanol poisoning and policy mitigation strategies. Foods. 2021;10(7):1625.
  • Aghababaeian H, Ahvazi LA, Ostadtaghizadeh A. The Methanol Poisoning Outbreaks in Iran 2018. Alcohol and Alcoholism, 2019, 54(2) 128–130.
  • Kacer I, Caglar A. A growing problem of methanol poisonings: A retrospective analysis of 47 patients in a single-centre in Turkey. Ann Med Res. 2021;28(12):2179–82.
  • Kalkan S, Cevik AA, Cavdar C, et al. Acute methanol poisonings reported to the Drug and Poison Information Center in Izmir, Turkey. Vet Hum Toxicol. 2003 Dec;45(6):334–7.
  • Hadipourzadeh M, Ebrahimi S, Ziaeefar P, Zamani N, Falahaty H, Robert D, et al. Comparing the Clinical Characteristics, Laboratory Findings, and Outcomes between Epidemic and Episodic Methanol Poisoning Referrals; a Cross-sectional Study. Arch Acad Emerg Med. 2021;9(1).
  • Graw M, Haffner HT, Althaus L, Besserer K, Voges S. Invasion and distribution of methanol. Arch Toxicol. 2000 Aug;74(6);p.313–21.
  • Wiener SW. Toxic Alcohols. Goldfrank’s Toxicol Emergencies. Hoffman, RS, Howland, MA, Lewin, NA, Nelson, LS, Goldfrank, LR, Eds. 10th ed.Mc Graw Hill; 2015;p.1346–58.
  • Rietjens SJ, de Lange DW, Meulenbelt J. Ethylene glycol or methanol intoxication: which antidote should be used, fomepizole or ethanol? Neth J Med. 2014 Feb;72(2):73–9.
  • Tian M, He H, Liu Y, Li R, Zhu B, Cao Z. Fatal methanol poisoning with different clinical and autopsy findings: Case report and literature review. Leg Med. 2022;54:101995.
  • Brahmi N, Blel Y, Abidi N, Kouraichi N, Thabet H, Hedhili A, et al. Methanol poisoning in Tunisia: report of 16 cases. Clin Toxicology (Phila). 2007;45(6):717–20.
  • Karimi S, Arabi A, Shahraki T. Alcohol and the Eye. J Ophthalmic Vis Res. 2021;16(2):260.
  • 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 Toxicology (Phila). 2012 Nov;50(9):823–31.
  • Desai T, Sudhakar A, Vyas U, Khamar B. Methanol poisoning: predictors of visual outcomes. JAMA Ophthalmol. 2013 Mar;131(3):358–64.
  • Kute VB, Godara SM, Shah PR, Gumber MR, Goplani KR, Vanikar AV, et al. Hemodialysis for methyl alcohol poisoning: A single-centre experience. Saudi J Kidney Dis Transpl 2012;23:37-43.
  • Hantson P, Mahieu P. Pancreatic injury following acute methanol poisoning. J Toxicol Clin Toxicol. 2000;38(3):297–303.
  • Mégarbane B. Treatment of patients with ethylene glycol or methanol poisoning: focus on fomepizole. Open Access Emerg Med. 2010;2:67–75.
  • Julian T, Glascow N, Syeed R, Zis P. Alcohol-related peripheral neuropathy: a systematic review and meta-analysis. J Neurol. 2019 Dec;266(12):2907–19.
There are 27 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Taner Şahin 0000-0002-7783-5343

Oğuzhan Bol 0000-0002-7323-0355

Mükerrem Altuntaş 0000-0001-5775-3909

Publication Date October 20, 2022
Acceptance Date October 1, 2022
Published in Issue Year 2022

Cite

APA Şahin, T., Bol, O., & Altuntaş, M. (2022). Retrospective Analysis of Methyl Alcohol Poisonings Admitted to the Emergency Department. Konuralp Medical Journal, 14(3), 503-511. https://doi.org/10.18521/ktd.1147742
AMA Şahin T, Bol O, Altuntaş M. Retrospective Analysis of Methyl Alcohol Poisonings Admitted to the Emergency Department. Konuralp Medical Journal. October 2022;14(3):503-511. doi:10.18521/ktd.1147742
Chicago Şahin, Taner, Oğuzhan Bol, and Mükerrem Altuntaş. “Retrospective Analysis of Methyl Alcohol Poisonings Admitted to the Emergency Department”. Konuralp Medical Journal 14, no. 3 (October 2022): 503-11. https://doi.org/10.18521/ktd.1147742.
EndNote Şahin T, Bol O, Altuntaş M (October 1, 2022) Retrospective Analysis of Methyl Alcohol Poisonings Admitted to the Emergency Department. Konuralp Medical Journal 14 3 503–511.
IEEE T. Şahin, O. Bol, and M. Altuntaş, “Retrospective Analysis of Methyl Alcohol Poisonings Admitted to the Emergency Department”, Konuralp Medical Journal, vol. 14, no. 3, pp. 503–511, 2022, doi: 10.18521/ktd.1147742.
ISNAD Şahin, Taner et al. “Retrospective Analysis of Methyl Alcohol Poisonings Admitted to the Emergency Department”. Konuralp Medical Journal 14/3 (October 2022), 503-511. https://doi.org/10.18521/ktd.1147742.
JAMA Şahin T, Bol O, Altuntaş M. Retrospective Analysis of Methyl Alcohol Poisonings Admitted to the Emergency Department. Konuralp Medical Journal. 2022;14:503–511.
MLA Şahin, Taner et al. “Retrospective Analysis of Methyl Alcohol Poisonings Admitted to the Emergency Department”. Konuralp Medical Journal, vol. 14, no. 3, 2022, pp. 503-11, doi:10.18521/ktd.1147742.
Vancouver Şahin T, Bol O, Altuntaş M. Retrospective Analysis of Methyl Alcohol Poisonings Admitted to the Emergency Department. Konuralp Medical Journal. 2022;14(3):503-11.