Abstract
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.
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Data Availability
The dataset used and/or analyzed during the current study is available from the corresponding author on reasonable request.
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Acknowledgements
The authors extend their appreciation to Dr. Aeshah Saud Alatawi and Dr. Nasser Ali Alasmari for facilitating data collection.
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A. Sharif conceptualized the study, analyzed, and interpreted the data; the corresponding author wrote the manuscript draft, proofread it, and approved the final manuscript.
M. AlAmeer conceptualized the study, collected the data, obtained ethical approval, and approved the final manuscript.
D. AlSubaie conceptualized the study, collected the data, obtained ethical approval, and approved the final manuscript.
N. Alarfaj conceptualized the study, collected the data, obtained ethical approval, and approved the final manuscript.
M. AlDawsari conceptualized the study, collected the data, and approved the final manuscript.
K. AlAslai conceptualized the study, collected the data, and approved the final manuscript.
M. BuSaleh conceptualized the study, collected the data, and approved the final manuscript.
AlSabr conceptualized the study, collected the data, and approved the final manuscript.
K. Al-Mulhim supervised the data collection, obtained ethical approval, interpreted the data, proofread the manuscript, and approved the final manuscript.
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The current study was carried out following the Declaration of Helsinki. Ethical approvals were obtained from the institutional review boards from King Saud Medical City (IRB Number: H1R1-30-Dec20-01), King Fahad Medical City (IRB Log Number:21-024), and College of Medicine, Dar Al-Uloom University (IRB Number: Pro 20110001).
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Not applicable as the current study was conducted retrospectively and informed consents were waived by IRB committees. Data were retrieved from the medical records without personal identity declaration to maintain the confidentiality of the patients
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The authors declare no competing interests.
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Sharif, A.F., AlAmeer, M.R., AlSubaie, D.S. et al. Predictors of poor outcomes among patients of acute methanol intoxication with particular reference to Sequential Organ Failure Assessment (SOFA) score. Environ Sci Pollut Res 28, 60511–60525 (2021). https://doi.org/10.1007/s11356-021-14998-w
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DOI: https://doi.org/10.1007/s11356-021-14998-w