Risk factors for mortality in Asian Taiwanese patients with methanol poisoning.
BACKGROUND
Methanol poisoning continues to be a serious public health issue in Taiwan, but very little work has been done to study the outcomes of methanol toxicity in the Asian population. In this study, we examined the value of multiple clinical variables in predicting mortality after methanol exposure.


METHODS
We performed a retrospective observational study on patients with acute poisoning who were admitted to the Chang Gung Memorial Hospital over a period of 9 years (2000-2008). Out of the 6,347 patients, only 32 suffered methanol intoxication. The demographic, clinical, laboratory, and mortality data were obtained for analysis.


RESULTS
Most patients were middle aged (46.1±13.8 years), male (87.5%), and habitual alcohol consumers (75.0%). All the poisonings were from an oral exposure (96.9%), except for one case of intentionally injected methanol (3.1%). After a latent period of 9.3±10.1 hours, many patients began to experience hypothermia (50.0%), hypotension (15.6%), renal failure (59.4%), respiratory failure (50.0%), and consciousness disturbance (Glasgow coma scale [GCS] score 10.5±5.4). Notably, the majority of patients were treated with ethanol antidote (59.4%) and hemodialysis (58.1%). The remaining 41.6% of patients did not meet the indications for ethanol therapy. At the end of analysis, there were six (18.8%), 15 (46.9%), and eleven (34.4%) patients alive, alive with chronic complications, and dead, respectively. In a multivariate Cox regression model, it was revealed that the GCS score (odds ratio [OR] 0.816, 95% confidence interval [CI] 0.682-0.976) (P=0.026), hypothermia (OR 168.686, 95% CI 2.685-10,595.977) (P=0.015), and serum creatinine level (OR 4.799, 95% CI 1.321-17.440) (P=0.017) were significant risk factors associated with mortality.


CONCLUSIONS
The outcomes (mortality rate 34.4%) of the Taiwanese patients subjected to intensive detoxification protocols were comparable with published data from other international poison centers. Furthermore, the analytical results indicate that GCS score, hypothermia, and serum creatinine level help predict mortality after methanol poisoning.
Department of Nephrology and Division of Clinical Toxicology, Taipei, Taiwan.
Chen-Yen
CY
Lee
Department of Nephrology and Division of Clinical Toxicology, Taipei, Taiwan.
Eileen Kevyn
EK
Chang
Department of Nephrology and Division of Clinical Toxicology, Taipei, Taiwan.
Ja-Liang
JL
Lin
Department of Nephrology and Division of Clinical Toxicology, Taipei, Taiwan.
Cheng-Hao
CH
Weng
Department of Nephrology and Division of Clinical Toxicology, Taipei, Taiwan.
Shen-Yang
SY
Lee
Department of Nephrology and Division of Clinical Toxicology, Taipei, Taiwan.
Kuo-Chang
KC
Juan
Department of Nephrology and Division of Clinical Toxicology, Taipei, Taiwan.
Huang-Yu
HY
Yang
Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.
Chemin
C
Lin
Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.
Shwu-Hua
SH
Lee
Department of Nephrology, China Medical University Hospital and China Medical University, Taichung, Taiwan.
I-Kwan
IK
Wang
Department of Nephrology and Division of Clinical Toxicology, Taipei, Taiwan.
Tzung-Hai
TH
Yen
ethanol; hemodialysis; intoxication; mortality; wood alcohol