PMID- 31298045
OWN - NLM
STAT- MEDLINE
DCOM- 20201013
LR  - 20201013
IS  - 1556-9519 (Electronic)
IS  - 1556-3650 (Linking)
VI  - 58
IP  - 4
DP  - 2020 Apr
TI  - The impact of co-morbidities on a 6-year survival after methanol mass poisoning 
      outbreak: possible role of metabolic formaldehyde.
PG  - 241-253
LID - 10.1080/15563650.2019.1637525 [doi]
AB  - 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 < .05). All patients who 
      died in the hospital had at least one complication. A higher ACCI score was 
      associated with greater total mortality (HR 1.22; 1.00-1.48 95% CI; p = .046). Of 
      those who died, 35 (90%) had a moderate-to-high ACCI. The Kaplan-Meier curve 
      demonstrated that patients with a high ACCI had greater follow-up mortality 
      compared to ones with low (p = .027) or moderate (p = .020) scores. For the 
      patients who died during follow-up, cancers of different localizations were 
      responsible for 7/15 (47%) of the deaths.Conclusions: The character and number of 
      complications affected hospital but not follow-up mortality, while the burden of 
      co-morbidities affected follow-up mortality. Methanol-induced brain lesions did 
      not affect follow-up mortality. Relatively high cancer mortality rate may be 
      associated with acute exposure to metabolic formaldehyde produced by methanol 
      oxidation.
FAU - Zakharov, Sergey
AU  - Zakharov S
AD  - Department of Occupational Medicine, First Faculty of Medicine, Charles 
      University, Prague, Czech Republic.
AD  - Toxicological Information Centre, General University Hospital, Prague, Czech 
      Republic.
FAU - Rulisek, Jan
AU  - Rulisek J
AD  - Department of Anesthesia and Intensive Care, First Faculty of Medicine, Charles 
      University and General University Hospital, Prague, Czech Republic.
FAU - Hlusicka, Jiri
AU  - Hlusicka J
AD  - Department of Occupational Medicine, First Faculty of Medicine, Charles 
      University, Prague, Czech Republic.
AD  - Toxicological Information Centre, General University Hospital, Prague, Czech 
      Republic.
FAU - Kotikova, Katerina
AU  - Kotikova K
AD  - Department of Occupational Medicine, First Faculty of Medicine, Charles 
      University, Prague, Czech Republic.
AD  - Toxicological Information Centre, General University Hospital, Prague, Czech 
      Republic.
FAU - Navratil, Tomas
AU  - Navratil T
AD  - Toxicological Information Centre, General University Hospital, Prague, Czech 
      Republic.
AD  - Department of Biomimetic Electrochemistry, J. Heyrovsky Institute of Physical 
      Chemistry of the Czech Academy of Sciences, Prague, Czech Republic.
FAU - Komarc, Martin
AU  - Komarc M
AD  - Department of Methodology, Faculty of Physical Education and Sport, Charles 
      University, Prague, Czech Republic.
FAU - Vaneckova, Manuela
AU  - Vaneckova M
AD  - Department of Radiology, First Faculty of Medicine, Charles University and 
      General University Hospital, Prague, Czech Republic.
FAU - Seidl, Zdenek
AU  - Seidl Z
AD  - Department of Radiology, First Faculty of Medicine, Charles University and 
      General University Hospital, Prague, Czech Republic.
FAU - Diblik, Pavel
AU  - Diblik P
AD  - Department of Ophthalmology, First Faculty of Medicine, Charles University and 
      General University Hospital, Prague, Czech Republic.
FAU - Bydzovsky, Jan
AU  - Bydzovsky J
AD  - Department of Ophthalmology, First Faculty of Medicine, Charles University and 
      General University Hospital, Prague, Czech Republic.
FAU - Heissigerova, Jarmila
AU  - Heissigerova J
AD  - Department of Ophthalmology, First Faculty of Medicine, Charles University and 
      General University Hospital, Prague, Czech Republic.
FAU - Zogala, David
AU  - Zogala D
AD  - Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and 
      General University Hospital, Prague, Czech Republic.
FAU - Hubacek, Jaroslav A
AU  - Hubacek JA
AD  - Center for Experimental Medicine, Institute for Clinical and Experimental 
      Medicine, Prague, Czech Republic.
FAU - Miovsky, Michal
AU  - Miovsky M
AD  - Department of Addictology, First Faculty of Medicine, Charles University in 
      Prague and General University Hospital, Prague, Czech Republic.
FAU - Sejvl, Jaroslav
AU  - Sejvl J
AD  - Department of Addictology, First Faculty of Medicine, Charles University in 
      Prague and General University Hospital, Prague, Czech Republic.
FAU - Vojtova, Lucie
AU  - Vojtova L
AD  - Institute of Clinical Biochemistry and Laboratory Diagnostics, First Faculty of 
      Medicine, Charles University and General University Hospital, Prague, Czech 
      Republic.
FAU - Pelclova, Daniela
AU  - Pelclova D
AD  - Department of Occupational Medicine, First Faculty of Medicine, Charles 
      University, Prague, Czech Republic.
AD  - Toxicological Information Centre, General University Hospital, Prague, Czech 
      Republic.
LA  - eng
PT  - Journal Article
DEP - 20190712
PL  - England
TA  - Clin Toxicol (Phila)
JT  - Clinical toxicology (Philadelphia, Pa.)
JID - 101241654
RN  - 1HG84L3525 (Formaldehyde)
RN  - Y4S76JWI15 (Methanol)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cohort Studies
MH  - Disease Outbreaks/statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - Formaldehyde/metabolism/*poisoning
MH  - *Hospital Mortality
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Methanol/pharmacokinetics/*poisoning
MH  - Middle Aged
MH  - Poisoning/epidemiology/*mortality
MH  - Prospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Young Adult
OTO - NOTNLM
OT  - Acute methanol poisoning
OT  - co-morbidities
OT  - complications
OT  - follow-up mortality
OT  - formaldehyde
OT  - hospital mortality
OT  - prognosis
EDAT- 2019/07/13 06:00
MHDA- 2020/10/21 06:00
CRDT- 2019/07/13 06:00
PHST- 2019/07/13 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
PHST- 2019/07/13 06:00 [entrez]
AID - 10.1080/15563650.2019.1637525 [doi]
PST - ppublish
SO  - Clin Toxicol (Phila). 2020 Apr;58(4):241-253. doi: 10.1080/15563650.2019.1637525. 
      Epub 2019 Jul 12.