Metanol Zehirlenmesinde Erken Mortalite Öngörüsünde Laktat Düzeyleri, Bikarbonat ve Lökosit-Glukoz İndeksinin (LGI) Prognostik Değeri

Öz

Amaç: Metanol zehirlenmesi, ciddi metabolik asidoz ve yüksek mortalite ile ilişkili, yaşamı tehdit eden bir durumdur. Bu çalışmada, laktat, bikarbonat ve lökosit-glukoz indeksinin erken mortaliteyi öngörmedeki prognostik değerinin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Bu retrospektif çalışmaya, Ekim 2020 ile Ekim 2024 tarihleri arasında üçüncü basamak bir acil servise başvuran 45 erişkin hasta dahil edildi. Demografik özellikler, vital bulgular ve hematolojik ile biyokimyasal parametreler kaydedildi. Nötrofil-lenfosit oranı, trombosit-lenfosit oranı, pan-immün-inflamasyon değeri ve lökosit-glukoz indeksi gibi inflamatuvar indeksler hesaplandı. Sağ kalan ve yaşamını kaybeden hastalar karşılaştırıldı. Mortalitenin bağımsız belirleyicileri lojistik regresyon analizi ile belirlendi ve prognostik performans eğri altındaki alan değerleri kullanılarak değerlendirildi. Bulgular: Yaşamını kaybeden hastalar daha ileri yaşta olup daha düşük kan basıncı, oksijen satürasyonu ve bikarbonat düzeylerine sahipti; buna karşın laktat ve lökosit-glukoz indeksi değerleri daha yüksekti. Lojistik regresyon analizinde düşük bikarbonat ve yüksek laktat düzeyleri mortalitenin bağımsız belirleyicileri olarak saptandı. Bikarbonat ve laktat güçlü prognostik performans gösterdi ve sırasıyla 10,15 mmol/L ve 5,05 mmol/L eşik değerleri belirlendi. Lökosit-glukoz indeksi de iyi düzeyde öngörü doğruluğu gösterdi. Sonuç: Laktat, bikarbonat ve lökosit-glukoz indeksi, metanol zehirlenmesinde erken mortalite riskinin belirlenmesinde pratik ve güvenilir belirteçlerdir. Bu parametrelerin ilk klinik değerlendirmeye dahil edilmesi erken karar verme süreçlerini destekleyebilir ve hasta sonuçlarını iyileştirebilir.

Anahtar Kelimeler

• Metanol zehirlenmesi
• laktat
• bikarbonat
• lökosit-glukoz indeksi
• mortalite öngörüsü

Destekleyen Kurum

Bu araştırma, kamu, ticari veya kar amacı gütmeyen sektörlerdeki herhangi bir fon kuruluşundan özel bir hibe almamıştır.

Etik Beyan

Çalışma, Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür. Bu çalışma için Kırşehir Ahi Evran Üniversitesi Tıp Fakültesi Sağlık Bilimleri Bilimsel Araştırma Etik Kurulu'ndan etik onay alınmıştır (Karar No: 2025-10/114, Tarih: 27 Mayıs 2025). Çalışma protokolü ve ilgili belgeler, araştırmanın başlatılmasından önce etik kurul tarafından incelenmiş ve bilimsel ve etik açıdan uygun bulunmuştur.

PROGNOSTIC VALUE OF LACTATE LEVELS, BICARBONATE, AND LEUKOCYTE-GLUCOSE INDEX IN EARLY MORTALITY PREDICTION IN METHANOL POISONING

Öz

Objective: Methanol poisoning is a life-threatening condition associated with severe metabolic acidosis and high mortality. This study aimed to evaluate the prognostic value of lactate, bicarbonate, and the leukocyte-glucose index in predicting early mortality. Material and Methods: This retrospective study included 45 adult patients admitted to a tertiary emergency department between October 2020 and October 2024. Demographic characteristics, vital signs, and laboratory parameters were recorded. Inflammatory indices were calculated. Survivors and non-survivors were compared, and independent predictors of mortality were determined using logistic regression analysis. Prognostic performance was evaluated using receiver operating characteristic analysis. Results: Non-survivors were older and had lower blood pressure, oxygen saturation, and bicarbonate levels, while lactate and leukocyte-glucose index values were higher. Decreased bicarbonate and increased lactate levels were identified as independent predictors of mortality. Bicarbonate and lactate showed strong prognostic performance, with cut-off values of 10.15 mmol/L and 5.05 mmol/L, respectively. The leukocyte-glucose index also demonstrated good predictive accuracy. Conclusion: Lactate, bicarbonate, and the leukocyte-glucose index are practical and reliable markers for early mortality risk stratification in methanol poisoning.

Anahtar Kelimeler

• Methanol poisoning
• lactate
• bicarbonate
• leukocyte-glucose index
• mortality prediction

Destekleyen Kurum

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Etik Beyan

The study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval for this study was obtained from the Kırşehir Ahi Evran University Faculty of Medicine Health Sciences Scientific Research Ethics Committee (Decision No: 2025-10/114, Date: 27 May 2025). The study protocol and related documents were reviewed by the ethics committee and approved as scientifically and ethically appropriate before the initiation of the research.

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