The impact of co-morbidities on a 6-year survival after methanol mass poisoning outbreak: possible role of metabolic formaldehyde

• Published in: Clinical toxicology (Philadelphia, Pa.) Pa.), 2020-04, Vol.58 (4), p.241-253
• Main Authors: Zakharov, Sergey, Rulisek, Jan, Hlusicka, Jiri, Kotikova, Katerina, Navratil, Tomas, Komarc, Martin, Vaneckova, Manuela, Seidl, Zdenek, Diblik, Pavel, Bydzovsky, Jan, Heissigerova, Jarmila, Zogala, David, Hubacek, Jaroslav A., Miovsky, Michal, Sejvl, Jaroslav, Vojtova, Lucie, Pelclova, Daniela
• Format: Article
• Language: English
• Subjects: Acute methanol poisoning; co-morbidities; complications; follow-up mortality; formaldehyde; hospital mortality; prognosis
• ISSN: 1556-3650; 1556-9519
• DOI: 10.1080/15563650.2019.1637525

Context: The influence of co-morbid conditions on the outcome of acute methanol poisoning in mass poisoning outbreaks is not known. Objective: The objective of this is to study the impact of burden of co-morbidities, complications, and methanol-induced brain lesions on hospital, follow-up, and total mortality. Methods: All patients hospitalized with methanol poisoning during a mass poisoning outbreak were followed in a prospective cohort study until death or final follow-up after 6 years. The age-adjusted Charlson co-morbidity index (ACCI) score was calculated for each patient. A multivariate Cox regression model was used to calculate the adjusted hazards ratio (HR) for death. The survival was modeled using the Kaplan-Meier method. Results: Of 108 patients (mean age with SD 50.9 ± 2.6 years), 24 (54.4 ± 5.9 years) died during hospitalization (mean survival with SD 8 ± 4 days) and 84 (49.9 ± 3.0 years; p = .159) were discharged, including 27 with methanol-induced brain lesions. Of the discharged patients, 15 (56.3 ± 6.8 years) died during the follow-up (mean survival 37 ± 11 months) and 69 (48.5 ± 3.3 years; p = .044) survived. The hospital mortality was 22%, the follow-up mortality was 18%; the total mortality was 36%. Cardiac/respiratory arrest, acute respiratory failure, multiorgan failure syndrome, and arterial hypotension increased the HR for hospital and total (but not follow-up) mortality after adjustment for age, sex, and arterial pH (all p