Review of METHYL alcohol intoxication and determination of factors affecting mortality

Objective: We aimed to investigate the demographic data, laboratory findings, treatment modalities and clinical outcomes of patients evaluated in the emergency department with methanol intoxication. Secondarily, we aimed to determine the variables predicting the need for hemodialysis and mortality. Patients and Methods: Sixty-four patients aged 18 years and older who were admitted to Ondokuz Mayıs University Faculty of Medicine Adult Emergency Department with the suspicion of methanol intoxication between 1 January 2010 and 15 November 2022 enrolled to this retrospective cross-sectional study. Patients' demographic data, vital signs, laboratory parameters, end-organ injury status, clinical outcome and treatment modalities were analyzed. Results: The mean age of the study patients was 47.7±12.0 years. 59 (92.2%) of the patients were male, and 35 (40.6%) had consumed homemade alcohol. The most common presenting complaint was visual impairment with a rate of 39.1% (n=25). It was determined that 52 patients received ethanol treatment, 50 underwent hemodialysis treatment along with antidote therapy, 49 received bicarbonate treatment in conjunction with other therapies, and 23 received steroid treatment in combination with other therapies. According to end-organ effects, the central nervous system was found to be the most affected system (n=29, 45.3%). The 30-day mortality rate was 29.7% (n=19). When the laboratory results of the survived and dead patient groups were compared, sodium, potassium, creatinine, pH, bicarbonate, base deficit, lactate, anion gap, and osmolarity values were found to be statistically significant different. According to the results of ROC analysis, we found that blood gas pH, lactate, anion gap, bicarbonate, base deficit values were statistically significant variables in predicting mortality. In addition, when the effectiveness of these variables in determining the need for hemodialysis was evaluated, pH, bicarbonate and anion gap parameters were found to be statistically significant. Conclusion: In our study, we observed that patients with methanol poisoning have high mortality and morbidity. In patients, pH, lactate, bicarbonate, base deficit and anion gap are parameters that can be evaluated to predict mortality. Moreover, pH, bicarbonate and anion gap are parameters that can be evaluated to determine the need for hemodialysis treatment in patients.