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Predictors of poor outcomes among patients of acute methanol intoxication with particular reference to Sequential Organ Failure Assessment (SOFA) score
Environmental Science and Pollution Research ( IF 5.8 ) Pub Date : 2021-06-22 , DOI: 10.1007/s11356-021-14998-w
Asmaa Fady Sharif 1, 2 , Mahdi Riyadh AlAmeer 2, 3 , Duhaim Saad AlSubaie 2, 4 , Naser Husam Alarfaj 2, 5 , Mubarak Khalifah AlDawsari 2, 6 , Khalid Mansour AlAslai 2, 7 , Mahmoud Jawad BuSaleh 2 , Abdulaziz Ibrahim AlSabr 2 , Khalid Abdulmohsen Al-Mulhim 8
Affiliation  

Methanol intoxication is a global problem with serious morbidities and mortalities. Apart from the lifelong disabilities experienced by methanol intoxication survivors, mortality rates of up to 44% of exposed patients have been reported. The aim of the current study was to outline the early findings that could be utilized as effective in-hospital outcome predictors among cases of methanol exposure. Furthermore, the role of the Sequential Organ Failure Assessment (SOFA) score was evaluated as an early in-hospital outcome indicator among patients presented with acute methanol intoxication. A multicenter study including 37 patients diagnosed with acute methanol intoxication and referred to three major poison control centers in Saudi Arabia during the past 3 years (January 1, 2018–January 1, 2021) was conducted. Data including demographics, exposure history, presenting complaints, clinical findings, and laboratory investigation were collected. The patients were scored on Glasgow Coma Scale (GCS), Poison Severity Score (PSS), and SOFA score on admission. Out of the presented patients, 83.8% were alcoholic men. No deaths have been reported, and 51.4% were discharged with unfavorable outcomes, including 29.7% suffered optic neuropathy and blindness, 18.9% showed acute renal impairment, and 10.8% were complicated with respiratory failure. The diastolic blood pressure, anion gap, visual acuity, number of hemodialysis sessions, PSS, duration of Intensive Care Unit (ICU) stay, and SOFA score were all significant organ failure predictors (P < 0.05). However, only the SOFA score showed the best significant prediction on multivariate analysis, with an odds ratio (95% confidence interval) of 0.10 (0.04–0.17) and P = 0.003. At a cutoff of greater than 4.5, the SOFA score could significantly predict unfavorable outcomes with area under curve (AUC) = 0.955, accuracy 89.2%, specificity 94.4%, and sensitivity 84.2%. Early identification of methanol exposed patients at risk is critical and lifesaving. The SOFA score is a substantially useful and early inclusive unfavorable outcome predictor.



中文翻译:

急性甲醇中毒患者预后不良的预测因素,特别是参考序贯器官衰竭评估 (SOFA) 评分

甲醇中毒是一个具有严重发病率和死亡率的全球性问题。除了甲醇中毒幸存者的终身残疾外,据报道,甲醇中毒患者的死亡率高达 44%。本研究的目的是概述早期发现,这些发现可用作甲醇暴露病例中有效的院内结果预测因子。此外,顺序器官衰竭评估 (SOFA) 评分的作用被评估为急性甲醇中毒患者的早期住院结果指标。进行了一项多中心研究,包括 37 名被诊断患有急性甲醇中毒的患者,并在过去 3 年(2018 年 1 月 1 日至 2021 年 1 月 1 日)期间转诊到沙特阿拉伯的三个主要毒物控制中心。数据包括人口统计,收集暴露史、主诉、临床发现和实验室调查。入院时对患者进行格拉斯哥昏迷量表 (GCS)、中毒严重程度评分 (PSS) 和 SOFA 评分。在提出的患者中,83.8% 是酗酒的男性。无死亡病例,51.4%的患者出院时预后不良,其中29.7%的患者出现视神经病变和失明,18.9%的患者出现急性肾功能损害,10.8%的患者合并呼吸衰竭。舒张压、阴离子间隙、视力、血液透析次数、PSS、重症监护病房(ICU)住院时间和 SOFA 评分都是重要的器官衰竭预测因子。中毒严重程度评分 (PSS) 和入院时的 SOFA 评分。在提出的患者中,83.8% 是酗酒的男性。无死亡病例,51.4%的患者出院时预后不良,其中29.7%的患者出现视神经病变和失明,18.9%的患者出现急性肾功能损害,10.8%的患者合并呼吸衰竭。舒张压、阴离子间隙、视力、血液透析次数、PSS、重症监护病房(ICU)住院时间和 SOFA 评分都是重要的器官衰竭预测因子。中毒严重程度评分 (PSS) 和入院时的 SOFA 评分。在提出的患者中,83.8% 是酗酒的男性。无死亡病例,51.4%的患者出院时预后不良,其中29.7%的患者出现视神经病变和失明,18.9%的患者出现急性肾功能损害,10.8%的患者合并呼吸衰竭。舒张压、阴离子间隙、视力、血液透析次数、PSS、重症监护病房(ICU)住院时间和 SOFA 评分都是重要的器官衰竭预测因子。8%并发呼吸衰竭。舒张压、阴离子间隙、视力、血液透析次数、PSS、重症监护病房(ICU)住院时间和 SOFA 评分都是重要的器官衰竭预测因子。8%并发呼吸衰竭。舒张压、阴离子间隙、视力、血液透析次数、PSS、重症监护病房(ICU)住院时间和 SOFA 评分都是重要的器官衰竭预测因子。P < 0.05)。然而,只有 SOFA 评分显示了对多变量分析的最佳显着预测,优势比(95% 置信区间)为 0.10(0.04-0.17),P = 0.003。在大于 4.5 的临界值时,SOFA 评分可以显着预测不利结果,曲线下面积 (AUC) = 0.955、准确度 89.2%、特异性 94.4% 和灵敏度 84.2%。早期识别有风险的甲醇暴露患者至关重要且可以挽救生命。SOFA 评分是一个非常有用且包含早期不利结果的预测指标。

更新日期:2021-06-22
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