Christopher Hoyte1, Jonathan Schimmel2, Ali Hadianfar3, Shireen Banerji4, Samaneh Nakhaee5, Omid Mehrpour6,7. 1. University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 2. Department of Emergency Medicine, Division of Medical Toxicology, Mount Sinai Hospital Icahn School of Medicine, New York, NY, USA. 3. Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran. 4. Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA. 5. Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Birjand, Iran. 6. Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA. omid.mehrpour@yahoo.com.au. 7. Scientific Unlimited horizon, Tucson, AZ, USA. omid.mehrpour@yahoo.com.au.
Abstract
BACKGROUND: Toxic alcohol exposures are an ongoing concern in the United States. In the US, few studies characterize the local epidemiology of toxic alcohols over time. OBJECTIVES: The objective was to examine the incidence of toxic alcohol ingestions and changes in management over time. METHODS: This retrospective cohort study evaluates toxic alcohol ingestion phone calls to a regional poison center in the United States covering four states. Data were queried for this poison center from the National Poison Data System (NPDS) using generic codes for each toxic alcohol. Inclusion criteria were ingestion of toxic alcohol, age ≥ 13 years, from January 1, 2000 to Dec 31, 2017. Exclusion criteria were unrelated effects coded in the medical outcome, duplicate data, or incomplete demographic data. RESULTS: Of 926 subjects (adults and teenagers), 71.5% were male, and the mean age was 34.5 years. Toxic alcohol ingestion was more common in individuals younger than 40 years, with a significant relationship between age and intentional abuse or misuse (p = 0.001). There was also a significant relationship between age and reason for ingestion, with younger patients more likely to be suicidal (p < 0.001). Ethyleneglycol was the most common toxic alcohol. There was no change in the incidence of toxic alcohol ingestions over the study period. The mortality rate was 1.7%, and 31.2%of patients were hospitalized in a critical care unit. Major effects and death were more common in younger patients (p < 0.001). There was a significant difference in medical outcomes based on the type of toxic alcohol(p = 0.03). Fomepizole was the most common treatment. A Poisson regression model found no change in fomepizole use during the study period (p = 0.1). Ethanol administration over the study period increased (p = 0.02), while hemodialysis decreased (p = 0.02). CONCLUSION: Data obtained from a single regional United States poison center showed low mortality related to toxic alcohol ingestions. The most prevalent toxic alcohol was Ethylene glycol. In all cases, toxic alcohol ingestion was higher in the 20-29-year-old age group. Reasons for ingestion, in most cases, were suicidal. Fomepizole was the most common treatment, ethanol administration as an antidote is rising, and hemodialysis utilization is decreasing. Data may not be nationally representative.
BACKGROUND: Toxic alcohol exposures are an ongoing concern in the United States. In the US, few studies characterize the local epidemiology of toxic alcohols over time. OBJECTIVES: The objective was to examine the incidence of toxic alcohol ingestions and changes in management over time. METHODS: This retrospective cohort study evaluates toxic alcohol ingestion phone calls to a regional poison center in the United States covering four states. Data were queried for this poison center from the National Poison Data System (NPDS) using generic codes for each toxic alcohol. Inclusion criteria were ingestion of toxic alcohol, age ≥ 13 years, from January 1, 2000 to Dec 31, 2017. Exclusion criteria were unrelated effects coded in the medical outcome, duplicate data, or incomplete demographic data. RESULTS: Of 926 subjects (adults and teenagers), 71.5% were male, and the mean age was 34.5 years. Toxic alcohol ingestion was more common in individuals younger than 40 years, with a significant relationship between age and intentional abuse or misuse (p = 0.001). There was also a significant relationship between age and reason for ingestion, with younger patients more likely to be suicidal (p < 0.001). Ethyleneglycol was the most common toxic alcohol. There was no change in the incidence of toxic alcohol ingestions over the study period. The mortality rate was 1.7%, and 31.2%of patients were hospitalized in a critical care unit. Major effects and death were more common in younger patients (p < 0.001). There was a significant difference in medical outcomes based on the type of toxic alcohol(p = 0.03). Fomepizole was the most common treatment. A Poisson regression model found no change in fomepizole use during the study period (p = 0.1). Ethanol administration over the study period increased (p = 0.02), while hemodialysis decreased (p = 0.02). CONCLUSION: Data obtained from a single regional United States poison center showed low mortality related to toxic alcohol ingestions. The most prevalent toxic alcohol was Ethylene glycol. In all cases, toxic alcohol ingestion was higher in the 20-29-year-old age group. Reasons for ingestion, in most cases, were suicidal. Fomepizole was the most common treatment, ethanol administration as an antidote is rising, and hemodialysis utilization is decreasing. Data may not be nationally representative.
Authors: David D Gummin; James B Mowry; Michael C Beuhler; Daniel A Spyker; Daniel E Brooks; Katherine W Dibert; Laura J Rivers; Nathaniel P T Pham; Mark L Ryan Journal: Clin Toxicol (Phila) Date: 2020-12 Impact factor: 4.467
Authors: Katherine J Lepik; Adrian R Levy; Boris G Sobolev; Roy A Purssell; Christopher R DeWitt; Gunnar D Erhardt; James R Kennedy; Derek E Daws; Jane L Brignall Journal: Ann Emerg Med Date: 2008-07-18 Impact factor: 5.721
Authors: Sergey Zakharov; Jan Rulisek; Olga Nurieva; Katerina Kotikova; Tomas Navratil; Martin Komarc; Daniela Pelclova; Knut Erik Hovda Journal: Ann Intensive Care Date: 2017-07-20 Impact factor: 6.925