Toxic alcohol poisoning characteristics and treatments from 2000 to 2017 at a United States regional poison center.
Adolescent
Adult
Age Factors
Alcoholic Intoxication
/ drug therapy
Antidotes
/ therapeutic use
Ethylene Glycol
/ toxicity
Female
Fomepizole
/ therapeutic use
Humans
Incidence
Male
Middle Aged
Mortality
Poison Control Centers
Regression Analysis
Retrospective Studies
United States
/ epidemiology
Young Adult
Ethanol
Ethylene glycol
Fomepizole
Methanol
Toxic alcohol
United States
Journal
Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences
ISSN: 2008-2231
Titre abrégé: Daru
Pays: Switzerland
ID NLM: 101125969
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
03
06
2021
accepted:
30
09
2021
pubmed:
29
10
2021
medline:
1
3
2022
entrez:
28
10
2021
Statut:
ppublish
Résumé
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. The objective was to examine the incidence of toxic alcohol ingestions and changes in management over time. 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. 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). 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.
Sections du résumé
BACKGROUND
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
OBJECTIVE
The objective was to examine the incidence of toxic alcohol ingestions and changes in management over time.
METHODS
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 34709587
doi: 10.1007/s40199-021-00418-4
pii: 10.1007/s40199-021-00418-4
pmc: PMC8602461
doi:
Substances chimiques
Antidotes
0
Fomepizole
83LCM6L2BY
Ethylene Glycol
FC72KVT52F
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
367-376Informations de copyright
© 2021. Springer Nature Switzerland AG.
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