Metanol zehirlenmelerinde 9 yıllık acil servis deneyimi: retrospektif, gözlemsel bir çalışma

Öz

Amaç: Metanol zehirlenmesi, sıklıkla acil servislerde teşhis edilen ve ilk müdahalesi yapılan, hayati tehlike arz eden bir durumdur ve yüksek ölüm oranlarına sahip salgınlar şeklinde ortaya çıkabilir. Bu çalışma, metanol zehirlenmesi olan hastalarda mortalite ilişkili faktörleri belirlemeyi amaçlamıştır. Yöntem: Bu retrospektif çalışma, 9 yıllık bir dönemde klinik bulgular ve laboratuvar sonuçlarına göre metanol toksisitesi tanısı konulan 80 hastayı içermektedir. Bulgular: Mortalite oranı %31.25 idi (n=25). Ölen ve hayatta kalan hastalar arasında glukoz, pH, PCO2, HCO3, baz fazlalığı ve kreatinin düzeylerinde anlamlı farklılıklar gözlenmiştir (sırasıyla p=0.009, 0.001, 0.002, 0.001, 0.001 ve <0.001). Yoğun bakım ünitesine yatırılan hastalar, servise yatırılanlara kıyasla Glasgow Koma Skalası puanları açısından anlamlı olarak daha düşük ve baz açığı, HCO3 ve potasyum düzeyleri açısından farklılık göstermekteydi (sırasıyla p=0.023, 0.002, 0,009 ve 0,009). ROC analizi, pH ≤7.13'ü mortalitenin en güçlü öngörücüsü olarak belirledi (AUC=0.831, p=0.0001). Glasgow Koma Skorunun <15 olması da mortalite ile anlamlı bir şekilde ilişkiliydi (AUC=0.815, p=0.0001). Sonuç: pH, PCO₂, HCO₃ ve baz açığı gibi metabolik asidoz belirteçlerine ek olarak, kan şekeri ve parmak ucu oksijen saturasyonu gibi hızla elde edilebilen yatak başı parametreleri, metanol zehirlenmesinde prognoz ve mortaliteyi tahmin etmek için yararlı olabilir.

Anahtar Kelimeler

• Alkol zehirlenmesi
• acil servis
• etil alkol
• metabolik asidoz
• metil alkol

Destekleyen Kurum

yoktur

Etik Beyan

Çalışma için Mersin Üniversitesi Sağlık Bilimleri Araştırma Etik Kurulu’ndan 03/12/2025 tarihli 2025/01 sayılı onam alınmıştır.

Teşekkür

yok

9 Years of emergency department experience in methanol poisoning: a retrospective, observational study

Öz

Aim: Methanol intoxication is a life-threatening condition frequently diagnosed and initially managed in emergency departments and may occur in epidemic outbreaks with high mortality rates. This study aimed to identify factors associated with mortality in patients with methanol intoxication. Method: This retrospective study included 80 patients diagnosed with methanol toxicity based on clinical findings and laboratory results over a 9-year period. Results: The mortality rate was 31.25% (n=25). Significant differences were observed between survivors and non-survivors were observed in glucose, pH, PCO2, HCO3, base excess, and creatinine levels (p=0.009, 0.001, 0.002, 0.001, 0.001, and <0.001, respectively). Patients admitted to the intensive care unit had significantly lower Glasgow Coma Scale scores and significantly altered base excess, HCO3, and potassium levels compared with those admitted to the ward (p=0.023, 0.002, 0.009, and 0.009, respectively). ROC analysis identified a pH ≤7.13 as the strongest predictor of mortality (AUC=0.831, p=0.0001). A Glasgow Coma Scale <15 was also significantly associated with mortality (AUC=0.815, p=0.0001). Conclusion: In addition to markers of metabolic acidosis such as pH, PCO₂, HCO₃, and base deficit, rapidly obtainable bedside parameters, including blood glucose and finger-prick oxygen saturation, may be useful for predicting prognosis and mortality in methanol intoxication.

Anahtar Kelimeler

• Alcohol poisoning
• emergency department
• ethyl alcohol
• metabolic acidosis
• methyl alcohol

Destekleyen Kurum

None

Etik Beyan

Approval for the study was obtained from the Mersin University Health Sciences Research Ethics Committee on 03/12/2025, numbered 2025/01.

Teşekkür

None

Kaynakça

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