Öz
Aim: Underground alcoholic beverage production and consumption is an important problem in Türkiye and rest of the world. All alcohols, including ethanol, are known to have toxic effects. Patients may admit to emergency services with different clinical manifestations and laboratory findings after exposure to different doses. In this study, it was aimed to evaluate the patients with alcohol intoxication who admitted to the Emergency Medicine Department of Marmara University Pendik Training and Research Hospital.
Material and Methods: This study was carried out retrospectively on patients who admitted to the Emergency Department of Marmara University Pendik Training and Research Hospital between January 2016 and January 2021 due to alcohol poisoning. Demographic data of patients with alcohol intoxication, duration of admission to the hospital, time of admission, way of admission, state of consciousness, whether there was a concurrent different substance intake, whether there was concomitant trauma, blood gas results, whether they received renal replacement therapy and their outcomes were recorded.
Results: During the study period, 149 patients presented to the emergency department with the diagnosis of alcohol poisoning, and 0.5% (n=8) were considered exitus during their follow-up. 88.4% of the patients were male and the mean age was 35.5± 12.0 (minimum-maximum, 18-70)/year. A significant age difference was found between the patients who died after alcohol poisoning 49.5 (34.8-63.0) and the patients who survived 33.0 (26-41) in terms of age (p<0.05).
Conclusion: As a result, it was determined that alcohol intoxication is more common in middle-aged men, and it may be mortal in patients with low pH, HCO3, and increased base deficit and lactate values.
Anahtar Kelimeler
Ethanol methanol renal replacement therapy alcoholic intoxication
Kaynakça
- Satar S, Güüneysel ÖÖ, Tüüredi S, Yüürüümez Y, Akıcı A. Klinik Toksikoloji Tanı ve Tedavi. Alkoller ve Glikoller. Antalya. Çukurova Nobel Tıp Kitabevi, 2020. ISBN: 9786052369227
- Gulen M, Satar S, Avci A, Acehan S, Orhan U, Nazik H. Methanol poisoning in Turkey: Two outbreaks, a single center experience. Alcohol. 2020;88:83-90. DOI: 10.1016/j.alcohol.2020.07.002
- Kraut J, Kurtz I. Toxic alcohol ingestions: clinical features, diagnosis, and management. Clin J Am Soc Nephrol. 2008;3(1):208-25. DOI:10.2215/CJN.03220807
- Slaughter R, Mason R, Beasley D, et al. Isopropanol poisoning. Clin Toxicol (Phila). 2014;52(5):470-8. DOI: 10.3109/15563650.2014.914527
- Kraut J, Mullins M. Toxic Alcohols. N Engl J Med. 2018;378(3):270-80. DOI: 10.1056/NEJMra1615295
- Yayci N, Ağğritmiş H, Turla A, Koç S. Fatalities due to methyl alcohol intoxication in Turkey: an 8-year study. Forensic Sci Int. 2003;131(1):36-41. DOI:10.1016/s0379-0738(02)00376-6
- Rostrup M, Edwards JK, Abukalish M, Ezzabi M, Some D, Ritter H et al. The methanol poisoning outbreaks in Libya 2013 and Kenya 2014. PLoS One. 2016;11(3):e0152676. DOI: 10.1371/journal.pone.0152676
- Williams R, Erickson T. Evaluating toxic alcohol poisoning in the emergency setting. Lab Med. 1998;29(2):102-8. DOI:10.1093/labmed/29.2.102
- Resmî Gazete. https://www.resmigazete.gov.tr/eskiler/2019/01/201 90109.pdf (Erişşim tarihi: 20 Nisan 2021).
- Hovda KE, Hunderi OH, Tafjord AB, Dunlop O, Rudberg N, Jacobsen D. Methanol outbreak in Norway 2002-2004: Epidemiology, clinical features and prognostic signs. J Internal Med. 2005;258(2):181-90. DOI: 10.1111/j.1365-2796.2005.01521.x
- Zakharov S, Pelclova D, Urban P, Navratil T, Diblik P, Kuthan P et al. Czech mass methanol outbreak 2012: Epidemiology, challenges and clinical features Clinical Toxicology. 2014;52(10):1013-24. DOI: 10.3109/15563650.2014.974106
- Hassanian-Moghaddam H, Nikfarjam A, Mirafzal A, Saberinia A, Nasehi AA, Masoumi Asl H et al. Methanol mass poisoning in Iran: Role of case finding in outbreak management. J Public Heal (U. Kingdom). 2015;37(2):354-9. DOI: 10.1093/pubmed/fdu038
- Paasma R, Hovda KE, Hassanian-Moghaddam H, Brahmi N, Afshari R, Sandvik L et al. Risk factors related to poor outcome after methanol poisoning and the relation between outcome and antidotes a multicenter study. Clin Toxicol. 2012;50(9):823-31. DOI: 10.3109/15563650.2012.728224
- Zakharov S, Pelclova D, Urban P, Navratil T, Diblik P, Kuthan P et al. Czech mass methanol outbreak 2012: Epidemiology, challenges and clinical features Clinical Toxicology. 2014;52(10):1013-24. DOI: 10.3109/15563650.2014.974106
- Massoumi G, Saberi K, Eizadi-Mood N, Shamsi M, Alavi M, Morteza A. Methanol poisoning in Iran, from 2000 to 2009. Drug Chem Toxicol. 2012;35(3):330-3. DOI: 10.3109/01480545.2011.619193
- Ahmed F, Khan NU, Ali N, Feroze A. Methanol poisoning: 27 years experience at a tertiary care hospital. J Pak Med Assoc. 2017;67(11):1751-2. PMID: 29171574
- Callaghan M. A drink to die for: Arak and methanol poisoning in Indonesia. Travel Med Infect Dis. 2015;13(6):507-8. DOI: 10.1016/j.tmaid.2015.11.001
- Zyoud SH, Al-Jabi SW, Sweileh WM, Awang R, Waring WS. Bibliometric profile of the global scientific research on methanol poisoning (1902- 2012). J Occup Med Toxicol. 2015;10:17. DOI: 10.1186/s12995-015-0062-9
- Ashurst JV, Nappe TM. Methanol Toxicity. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482121/
- Celik S, Karapirli M, Kandemir E, Ucar F, Kantarci MN, Gurler M et al. Fatal ethyl and methyl alcohol- related poisoning in Ankara: A retrospective analysis of 10,720 cases between 2001 and 2011. J Forensic Leg Med. 2013;20(3):151-4. DOI: 10.1016/j.jflm.2012.05.009
- Paasma R, Hovda KE, Tikkerberi A, Jacobsen D. Methanol mass poisoning in Estonia: outbreak in 154 patients. Clin Toxicol (Phila). 2007;45(2):152- 7. DOI: 10.1080/15563650600956329
Öz
Amaç: Türkiye de ve dünyada kayıt dışı alkollü içecek üretimi ve tüketimi önemli bir sorundur. Etanol de dâhil olmak üzere bütün alkollerin toksik etkileri olduğu bilinmektedir. Farklı dozlarda alım sonrası farklı klinik ve laboratuvar bulgularıyla hastalar acil servislere başvurabilmektedir. Bu çalışmada, Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi Acil Tıp Kliniği ne başvuran alkol zehirlenmesi olan hastaların değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Bu çalışma, Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi Acil Servisi’ne Ocak 2016-Ocak 2021 tarihleri arasında alkol zehirlenmesi nedeniyle başvuran hastalar üzerinde retrospektif olarak yapılmıştır. Alkol zehirlenmesi olan hastaların demografik verileri, hastaneye başvuru süresi, başvuru zamanı, başvuru şekli, şuur durumu, farklı madde alımı olup olmadığı, travma olup olmadığı, kan gazı sonuçları, renal deplasman tedavisi alıp almadıkları ve sonlanımları kaydedildi.
Bulgular: ÇÇalışşma döönemi içinde 149 hasta acil servise alkol zehirlenmesi tanısı ile başvurmuş olup, bunların %0,5 (n= i takipleri sırasında eksitus kabul edildi. Hastaların % 88,4’ü erkek cinsiyette ve yaş ortalaması 35,5 12,0 (minimum-maksimum, 18-70)/yıl idi. Alkol zehirlenmesi sonrası eksitus olan hastalarla 49,5 (34,8-63,0), hayatta kalan hastalar arasında 33,0 (26-41) yaş
bakımından anlamlı fark saptandı (p<0,05).
Sonuç: Sonuç olarak alkol zehirlenmelerinin erkeklerde orta yaş grubunda daha sık göörüüldü ğ üü, dü ş üük pH, HCO3 ve artmış baz defisiti ve laktat değğerlerine sahip hastalarda ölümcül olabileceğği belirlendi.
Anahtar Kelimeler
Etanol metanol renal replasman tedavisi alkol intoksikasyonu
Kaynakça
- Satar S, Güüneysel ÖÖ, Tüüredi S, Yüürüümez Y, Akıcı A. Klinik Toksikoloji Tanı ve Tedavi. Alkoller ve Glikoller. Antalya. Çukurova Nobel Tıp Kitabevi, 2020. ISBN: 9786052369227
- Gulen M, Satar S, Avci A, Acehan S, Orhan U, Nazik H. Methanol poisoning in Turkey: Two outbreaks, a single center experience. Alcohol. 2020;88:83-90. DOI: 10.1016/j.alcohol.2020.07.002
- Kraut J, Kurtz I. Toxic alcohol ingestions: clinical features, diagnosis, and management. Clin J Am Soc Nephrol. 2008;3(1):208-25. DOI:10.2215/CJN.03220807
- Slaughter R, Mason R, Beasley D, et al. Isopropanol poisoning. Clin Toxicol (Phila). 2014;52(5):470-8. DOI: 10.3109/15563650.2014.914527
- Kraut J, Mullins M. Toxic Alcohols. N Engl J Med. 2018;378(3):270-80. DOI: 10.1056/NEJMra1615295
- Yayci N, Ağğritmiş H, Turla A, Koç S. Fatalities due to methyl alcohol intoxication in Turkey: an 8-year study. Forensic Sci Int. 2003;131(1):36-41. DOI:10.1016/s0379-0738(02)00376-6
- Rostrup M, Edwards JK, Abukalish M, Ezzabi M, Some D, Ritter H et al. The methanol poisoning outbreaks in Libya 2013 and Kenya 2014. PLoS One. 2016;11(3):e0152676. DOI: 10.1371/journal.pone.0152676
- Williams R, Erickson T. Evaluating toxic alcohol poisoning in the emergency setting. Lab Med. 1998;29(2):102-8. DOI:10.1093/labmed/29.2.102
- Resmî Gazete. https://www.resmigazete.gov.tr/eskiler/2019/01/201 90109.pdf (Erişşim tarihi: 20 Nisan 2021).
- Hovda KE, Hunderi OH, Tafjord AB, Dunlop O, Rudberg N, Jacobsen D. Methanol outbreak in Norway 2002-2004: Epidemiology, clinical features and prognostic signs. J Internal Med. 2005;258(2):181-90. DOI: 10.1111/j.1365-2796.2005.01521.x
- Zakharov S, Pelclova D, Urban P, Navratil T, Diblik P, Kuthan P et al. Czech mass methanol outbreak 2012: Epidemiology, challenges and clinical features Clinical Toxicology. 2014;52(10):1013-24. DOI: 10.3109/15563650.2014.974106
- Hassanian-Moghaddam H, Nikfarjam A, Mirafzal A, Saberinia A, Nasehi AA, Masoumi Asl H et al. Methanol mass poisoning in Iran: Role of case finding in outbreak management. J Public Heal (U. Kingdom). 2015;37(2):354-9. DOI: 10.1093/pubmed/fdu038
- Paasma R, Hovda KE, Hassanian-Moghaddam H, Brahmi N, Afshari R, Sandvik L et al. Risk factors related to poor outcome after methanol poisoning and the relation between outcome and antidotes a multicenter study. Clin Toxicol. 2012;50(9):823-31. DOI: 10.3109/15563650.2012.728224
- Zakharov S, Pelclova D, Urban P, Navratil T, Diblik P, Kuthan P et al. Czech mass methanol outbreak 2012: Epidemiology, challenges and clinical features Clinical Toxicology. 2014;52(10):1013-24. DOI: 10.3109/15563650.2014.974106
- Massoumi G, Saberi K, Eizadi-Mood N, Shamsi M, Alavi M, Morteza A. Methanol poisoning in Iran, from 2000 to 2009. Drug Chem Toxicol. 2012;35(3):330-3. DOI: 10.3109/01480545.2011.619193
- Ahmed F, Khan NU, Ali N, Feroze A. Methanol poisoning: 27 years experience at a tertiary care hospital. J Pak Med Assoc. 2017;67(11):1751-2. PMID: 29171574
- Callaghan M. A drink to die for: Arak and methanol poisoning in Indonesia. Travel Med Infect Dis. 2015;13(6):507-8. DOI: 10.1016/j.tmaid.2015.11.001
- Zyoud SH, Al-Jabi SW, Sweileh WM, Awang R, Waring WS. Bibliometric profile of the global scientific research on methanol poisoning (1902- 2012). J Occup Med Toxicol. 2015;10:17. DOI: 10.1186/s12995-015-0062-9
- Ashurst JV, Nappe TM. Methanol Toxicity. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482121/
- Celik S, Karapirli M, Kandemir E, Ucar F, Kantarci MN, Gurler M et al. Fatal ethyl and methyl alcohol- related poisoning in Ankara: A retrospective analysis of 10,720 cases between 2001 and 2011. J Forensic Leg Med. 2013;20(3):151-4. DOI: 10.1016/j.jflm.2012.05.009
- Paasma R, Hovda KE, Tikkerberi A, Jacobsen D. Methanol mass poisoning in Estonia: outbreak in 154 patients. Clin Toxicol (Phila). 2007;45(2):152- 7. DOI: 10.1080/15563650600956329
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Orijinal Çalışma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 6 Sayı: 3 |
