Gabriela Raluca Grigorasi1,2, Ionut Nistor3,4, Mihaela Corlade-Andrei3,5, Luminita Voroneanu3,4, Dimitrie Siriopol3,4, Mugurel Apetrei3,4, Diana Carmen Cimpoesu6,7, Adrian Covic3,4. 1. University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania. gabriela.tiulica@yahoo.com. 2. Emergency Department, Clinical Emergency County Hospital "St. Spiridon", Iasi, Romania. gabriela.tiulica@yahoo.com. 3. University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania. 4. Department of Nephrology, Dr CI Parhon" Hospital, Iasi, Romania. 5. Emergency Department, Clinical Emergency County Hospital "St. Spiridon", Iasi, Romania. 6. University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania. dcimpoiesu@yahoo.com. 7. Emergency Department, Clinical Emergency County Hospital "St. Spiridon", Iasi, Romania. dcimpoiesu@yahoo.com.
Abstract
BACKGROUND: Despite the severity of ethylene glycol intoxication, there is a paucity of studies that analyze prognostic factors. This study aims to determine prognostic factors with impact on core outcomes like death and prolonged kidney injury (KI) in ethylene glycol poisoned patients. METHODS: We retrospectively assessed prevalence, clinical and biochemical features in one large data set from two regional hospitals from the North-East region of Romania, between January 2012 and October 2017. Secondly, we compared prognostic factors of cases treated with dialysis plus antidote (N = 28 patients) with cases who received antidote only and supportive therapy (N = 28 patients). RESULTS: Of the 56 cases included, 16 deaths (28.57%) were recorded. The symptomatology at admission was more severe among patients requiring hemodialysis: a lower mean value for initial pH, lower initial alkaline reserve (AR) and higher mean values for initial serum creatinine (Cr1). The data analysis (survivors/deceased) showed a correlation between pH, Glasgow Coma Score (GCS), and increased mortality. In addition, we found a correlation between initial mean values for pH, AR (mmol/L), Cr1 (mg/dL), and peak Cr24 (mg/dL) with outcomes of RI or death. CONCLUSIONS: Compared with survivors, patients who died or had prolonged kidney injury were more likely to exhibit clinical signs such as coma, seizures, and acidosis. Hemodialysis and antidote should be started early and continued until acidosis is corrected.
BACKGROUND: Despite the severity of ethylene glycol intoxication, there is a paucity of studies that analyze prognostic factors. This study aims to determine prognostic factors with impact on core outcomes like death and prolonged kidney injury (KI) in ethylene glycol poisoned patients. METHODS: We retrospectively assessed prevalence, clinical and biochemical features in one large data set from two regional hospitals from the North-East region of Romania, between January 2012 and October 2017. Secondly, we compared prognostic factors of cases treated with dialysis plus antidote (N = 28 patients) with cases who received antidote only and supportive therapy (N = 28 patients). RESULTS: Of the 56 cases included, 16 deaths (28.57%) were recorded. The symptomatology at admission was more severe among patients requiring hemodialysis: a lower mean value for initial pH, lower initial alkaline reserve (AR) and higher mean values for initial serum creatinine (Cr1). The data analysis (survivors/deceased) showed a correlation between pH, Glasgow Coma Score (GCS), and increased mortality. In addition, we found a correlation between initial mean values for pH, AR (mmol/L), Cr1 (mg/dL), and peak Cr24 (mg/dL) with outcomes of RI or death. CONCLUSIONS: Compared with survivors, patients who died or had prolonged kidney injury were more likely to exhibit clinical signs such as coma, seizures, and acidosis. Hemodialysis and antidote should be started early and continued until acidosis is corrected.
Authors: Alexi Gugushvili; Aytalina Azarova; Darja Irdam; Whitney Crenna-Jennings; Michael Murphy; Martin McKee; Lawrence King Journal: Drug Alcohol Depend Date: 2018-05-01 Impact factor: 4.492
Authors: Merideth Prevost; Yijuan Sun; Karen S Servilla; Larry Massie; Robert H Glew; Antonios H Tzamaloukas Journal: Int Urol Nephrol Date: 2010-07-04 Impact factor: 2.370